10726_General Permit_19920313

`CAMA AND DREDGE AND FILL tu
GENERAL �J'
PERMIT w P �) coP N9 10726
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Ckmission
in an area of environmental concern pursuant to 15 NCAC �, /-1 / / o
Applicant N me // /_1, %% Phone Number %
Address
City �1 Lo L4 tate A� ( zip S'
Prrotje Locatio (County, State Road, Water Body, etc.) 117
Type of Project Activity eta
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
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max. distance offshore
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Basin, channel dimensions. 5,r�
cubic yards
Boat ramp dimensions
Other
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This permit is subject to compliance with this application, site \
drawing and attached general and specific conditions. Any /x
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. l/
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) this 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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
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applicant's signature
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permit officer's signature
issuing date expiration date
attachments / �14 C 7 P ' ir�
application fee# ��, /)0

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