23591_PINE KNOLL TOWNE I_19991020

• CAMA and DREDGE AND FILL
,.� G E N E R A L a; 3591—
i<
PERMIT
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC U /11. / .JfW .2.500
Applicant Name -%fJf i,E.%� drflif1� �d r-. Phone Number ,?Y%*26)0S'
Address
City // . J-1!d/�S State A)C Zip pgs-,, �2
Project Location (County, State Road, Water Body, etc.)
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Type of Project Activity --. acle-4 4'c�_ O/ gs-t = C.)
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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 become null and void.
This permit must be on the project site and accessible to the permit of-
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
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.
applicant's signature
�r.
permit officer's signature
issuing date
expiration date
attachments
In issuing this permit the State of North Carolina certifies thatthis project ��; C4
is consistent with the North Carolina Coastal Management Program. application fee

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US Postal Service
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**** U.S. POSTAL SERVICE ****
BEAUFORT 620 28516
360624 41.00
L SAIIOWSKI # 01
10-14-99 15:17:35f
CUSTOMER RECEIPT
-------------------------------
109 POST VAL IMP 2.65
TOTAL
CASH T 2.G5
CHANGE .00
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