26832_JOHEL, DAVE_20010228

CAMA and DREDGE AND FILL
G E N E R A L �
PERMIT -loci
as authorized by the State of North Carolina i 16u
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC a
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.) - , ,
Type of Project Activity
State
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
1 have no objections to the proposed work.
In issuing this permit the State of North Carolina certifies that this project
I consistent with the North Carolina Coastal Management Program,
.,
Phone Number _
zip
applicant's signature
4 permit officer's signature
issuing date expiration date
attachments
application fee