7569_KOSEMPLE, JOHN_19901024

CAMA AND DREDGE AND FILL 75694
PERMIT
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as authorized by the State of North Carolina, J7s:
Department of Natural Resources and Community Development a g oat Resources Commission
in an area of environmental concern pursuant to 15 NCAC�/,� j ��
Applicant Nam �� h �� Se w_a e, Phone Number
Address , ouiP 0Y Id /a
City, O✓I State
Project Location (County, State Road�j Water Body, etc.)
/_,
Type of Project Activity
2 1
PROJECT DESCRIPTION SKETCH
Pier (dock) length ! J
Groin length
number
Bulkhead length 7
max. distance offshore 2
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
Zip J1.%Z 7
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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_ applicant's signature
come null and void.
This permit must be on the project site and accessible to the permit officer's signature
permit officer when the project is inspected for compliance. I 0 /� / U
The applicant certifies by signing this permit that 1) this pro-
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 I��
objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that I
this project is consistent with the North Carolina Coastal application fee l�
Management Program.