23901_DAWSON, ROGER_19991110

CAMA and DREDGE AND FILL
G E N E R A L23911
PERMIT"T 1e�
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC M4. 2 c.;y0
Applicant Name Phone Number
Address
City C \ "I,\-, I A State NC- Zip Q1X)l 1
Project Location (County, State Road, Water Body, etc.) t >� C,, C4 �2^\1-`�1 c, i4�l,,4-„ 11<' A 4
Type of Project Activity
Y
PROJECT DESCRIPTION SKETCH
Pier (dock) Length �-,' 4' x cN In'
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
L�-.-s, �E
This permit is subject to compliance with this application, site drawing
and attached general and specific conditions. Any violation of these terms
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project is consistent with the local
land use plan and all local ordinances, and 2) a written statement has
been obtained from adjacent riparian landowners certifying that they
have no objections to the proposed work.
J
(SCALE: NQNQ
applicant's signature
permit officer's signature
� L) N QOM-n'Sr i� \56,-; 4 C Q\ U kE I Z UU V
issuing date expiration date
attachments
In issuing this permit the State of North Carolina certifies that this project_U �r ,�
is consistent with the North Carolina Coastal Management Program. application fee