19789_PALONE, F W_19990310

CAMA AND DREDGE AND FILL
GENERAL 0.9789 -b
-1�
PERMIT
as authorized by the State of North Carolina MAR 1
Department of Environment, Health, and Natural Resources and the6 199 Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant Name
Address
City
Project Location ,(County,tate Road, Water Body, etc
• ����r� r 4i s.✓7
Type of Project Activity ne k)
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
State I
Le
Phone Number
Zip
hint..—�—G
(SCALE: /•o / '� SC,. )
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any
violation of of these terms may subject the permittee to a fine,
imprisonment or civil action• and may cause the permit to be -
applicant's signature
come null and void.
This permit must be on the project site and accessible to the 6 permit o ficer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
ject
ro 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 �IVO
adjacent riparian landowners certifying that they have no
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---?
Management Program.