27227_SZYMANSKI, ED_20010501

CAMA and DREDGE AND FILL
G E N E R A L MAY 2 5 zoos
P E R M I T COASTAL ME-
'4NAGEMEN
as authorized by the State of North Carolina MOP HEAD
Department of Environment and Natural Resources and the Coasts e
in an area of environmental concern pursuant to 15 NCAC
Applicant Name;; t {tr2:` r l�l Phone Number
Address
City
Project Location (Count)4 State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH t _
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore Z ;V
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
y'
State _
iZ
zip
rces Commission
775�
t
(SCALE:
This permit is subject to compliance with this application, site drawing`]
and attached general and specific conditions. Any violation of these terms p
applicant's signature
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit of-
permit officer's signature
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project is consistent with the local
issuing date expiration date
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. ,
�
f I attachments
I! ••! / /,/ t7il
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program.
application fee