11208_General Permit_19940504

CAMA AND DREDGE AND F
GENERAL
MAY09
M
PERMIT
as authorized by the State of North Carolina �aw�sa�aa+�r•++�'
Department of Environment, Health, and NaturA4�Srces and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC %?!
Applicant Name Phone Number
Address
City State Zip
Project Location (County, State Road, Water Body, etc.) �
Type of Project Activity
t
11208-A
PROJECT DESCRIPTION
Pier (dock) length_
SKETCH
(SCALE:
)
I
, }Y
VEY
YN
€
r
.�
—
i
Groin length
number
Bulkhead length
,
j
max. distance offshore
Basin, channel dimensions
cubic yards
j
Boat ramp dimensions
4—
Other
This permit is subject to compliance with this application, site l '�
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. !
`c
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
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
this project is consistent with the North Carolina Coastal application fee
Management Program.
applicant's signature
permit officer's signature
expiration date