15940_GUTHRIE, BERNIE_19960201

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CAMA AND DREDGE AND FILL ' ` 015940
GENERAL -7
�3
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Appticant jslame?.Q �r� f .._t C.� ,, f % - �i% r'
f 1 -, Phone Number
Address 2"
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City Sr, t � / I State C zip 2 4'
Project Location (County, State Road, Water Body, etc.) '" �' �`� f f
Type of Project Activity
PROJECT DESCRIPTION I SKETCH G
Pier (dock) length
Groin length
number
Bulkhead length
t
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
,4 u k y -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 be-
come null and void.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
ject is consistent with the local land use plan and all local
ordinances, and 2) a written statement has l_e�n obtained from
a�jaceq.t�rlparian la,odoyvn.ers_._cer�.ifying_ ghat they have_ no
objections. to the proposed. work__
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
(SCALE
applicant's signature
permit officer's signature
issuing date expiration date
attachments
applicationfei('�"v�

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62502488278
ei NUMBER YEAR, MONTH, DAY POST OFFICE :. U. S. DOLLARS AND CENTS
CHECKWRITER
PAY TO
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IMPRINT AREA
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FROM
ADDRESS
COD NO.
USED FOR R GPc_ l.C;
1:00000800 21:
6 2 50 2 L,88 2 7811'
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