16612_FAKELMAN, ROBERT_19970319

CAMA AND DREDGE AND FILL
GENERAL
PERMIT
as authorized by the State of North Carolina g
Department of Environment, Health, and Natural Resoi
in an area of environmental concern pursuant to 15A N
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Applicant Name, 1\ � °' ! V (?% t" �-%
LAddress 2), 3 V x,
City Pi o d .11.1 h State _
Project Location (Couty, State Road, Water Body, etc.)( ky tJ 177 i14
Type of roject Activity L- JA + 41 0. d X
r7 1? D
PROJECT DESCRIPTION SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
l�;IS
ly tlq(g stal Resources Commission
Phone Number
Zip 6 R G
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A MAR 3 1'167'
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1IIID FI;.I IIIIL IJ JU V�VIiI LV VVIIIF/IIu11UU YYI LII LI IIJ Q+I F/IIN4LI VII, Jl ll. ^
drawing and attached general and specific conditions. Any Apo*
violation of these terms may subject the permittee to a fine,fes`-----
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imprisonment or civil action; and may cause the permit to be-
�
_ - applicant's signature
come null and void.
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't This permit must be on the project site and accessible to the
permftofficer's signature
f permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
I M
ject is consistent with the local land use plan and all local
issuing date
expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
r1 �) ' p
objections to the proposed work.
attachments
In issuing this permit the State of North Carolina certifies that
_
this project is consistent with the North Carolina Coastal
application fee 1:2 1
l Management Program.