15353_SHAVENDER, GUY_19960124

CAMA AND DREDGE AND
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GENERAL . FES 15
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PERMIT
as authorized by the State of North Carolir -1 -1- w��tarar tas�
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC C /01., C,-(,' I
Applicant Name t'' tc Y ) ri ,t') - f,
Address G�PJ0 f � C 6
City fl -It V14 f° {7
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ProjectLocation(County State Road Water Body,
Type of Project Activity
State A/ C'
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Phone Number C/ �, . '3�-1 � /
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PROJECT DESCRIPTION
SKETCH c ,
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Pier (dock) length
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out
Groin length
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number.
Bulkhead length — -
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max. distance offshore
Basin, channel dimensions
cubic yards
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Boat ramp dimensions
Other
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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 been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work.
n issuing this permit the State of North Carolina certifies that
his project is consistent with the North Carolina Coastal
lanagement Program.
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee