5517_BLACHOWICZ, ROVERT M_19890504

J
CAMA AND DREDGE AND FILL
GENERAL
PERMIT
as authorized by the State of North Carolina, 5517
Department of Natural Resources and Community Development a the al Reso c s �ission
in n area of environmental c7ern pursuant to 15 NCAC
Applicant Name 41, i'J� Phone Number
Address %
City �1
State Zip
Project Location (!"ounty, State Road, at r Body, etc.) <::�2-YV
Type of Pre t A wity hi` , 6 1�
�7Z
PROJECT DES:RIPTION I SKETCH
Pier (dock) length
Groin length.
number / -T
Bulkhead length
distance Ofr7ore
Basin, channel dimcsions
cubic yards
Boat ramp dimensirs
Other
This permit is sL:-.ezt to com liance with this application, si
drawing and atizned general and specific conditions. An
violation of then -erms may subject the permittee to a fine,
imprisonment o• .:.il action; and may cause the permit to
come null and vo_
This permit mus :e on the project site and accessible to ie
permit officer wen the project is inspected for compliance.
The applicant cc -.'es by signing this permit that 1) this pro-
ject is consister, .vith the local land use plan and all local
ordinances, and = i written statement has been obtained from
ndownetedlacent riparian tey ave no
(SCALE:
y
P� -,7-- "--?
applicant's signature
1 permit officer's signature
issuing date expiration date
attachments �//IX
ing this pc7:t the State of North Carolina certifies that
roject is Insistent with the North Carolina Coastal /' Z application fee �f�
;ment Pro--,. "

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