12007_NEWTON, DOUGLAS_19930718

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CAMA AND DREDGE AND FILL
GENERAL N0
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources C i Sion
in an area of environmental concern pursuant to 15 NCAC � f i nb
Applicant Name r J Phone Number
Address` �f -
City f�� �►� is��, State i '.1 Zip
Project Location (County, State Road, Water Body, etc.)
ry
Type of Project Activity
t
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length". -
.-r
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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.
(SCALE: )
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applicant's signature
--'— permit officer's signature
issuing Axpiration date
attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee t , () 0

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ELTON W. ELLIS JR
NC 1855620 PH 919-726-6775 66-152/531 CC -
Po Box 691 51 0
ATLANTIC BCH, NC 28512
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WA= a ` G Dollars
Wachovia Bank of North Carolina, N.A. Mord d ;ity, NC 28J57
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