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CAMA AND DREDGE AND FILL
GENERAL
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant Name' -' �"' ^ �G K` t Phone Number
Address
City r -- _
Project Location (County, State Road, Watery.
Typeof� ojec Activity C) lAL-
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PRO)EC DESCRIPTION SKETCH
Pier (dock) length i
Groin length
State _
etc.) �� t
number
Bulkhead length
max. distance offshore �.
Basin, channel dimensions ti +
cubic yards
Boat ramp dimensions rd
Other ! r
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This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any�►"'�rt�r�----_
" violation of these terms may subject the permittee to a fine,
"
applicant's signature
.' 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's signature
permit officer when the project is inspected for compliance.
O J
Y 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 expiration date
ordinances, and 2) a written statement has been obtained from
riparian landowners certifying that they have no
r� ,
V
adjacent
objections to the proposed work.
attachments
In issuing this permit the State of North Carolina certifies that
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this project is consistent with the North Carolina Coastal
application fee
Management Program.