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8256_KROZOK, MARTIN_19910830
,ut�t 4-- Pic Applicant Name Address City Project Location CAMA AND DREDGE AND FILL GENERAL PERMIT - as authorized by the State of North Carolina, Department of Natural Resources and Community Development andtfie Coastal Resou Cass�nl 1�9 in an area of environmental concern pursuant to 15 NCAC p© Phone Number ri ry, State Rgad, Water Body, etc.) Type of Project Activity State Zip PROJECT DESCRIPTION SKETCH P`T` (SCALE: Pier (dock) length Groin length (J�Q�^ v 4 u number Bulkhead length 3 6 max. dis nee offshore 4(2 r' Basin, channel dimensions / cubic yards Kr Boat ramp dimensions Other I 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) Qhis 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. �oR % applicant's signature permit officer's signature issuing date expiration date attachments In issuing this permit the State of North Carolina certifies that —6, -7� this project is consistent with the North Carolina Coastal application fee Management Program.