14967_MUDZIA, ROY_19951130

CAMA AND DREDGE .AND FILL O`
GENERAL
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PERMITkill
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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
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
Phone Number
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State A zip
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PROJECT DESCRIPTION
Pier (dock) length
SKETCH�"'
(SCALE:
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Groin length
number
Bulkhead length `-"
max. distance offshore
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Bazin, channel dimensions
cubic yards
Boat ramp dimensions
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Other
14—
i
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 be-
come null and void.
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 � a/written/statement has been obt�in.ed- from
adjacent ;-ripariaip landowners, certifying that 'the'y ?have` 'no
F
objet ohs'to f�k pyoposed.work.
applicant's
permit orrice
re
(01
issuing date expiration date
attachments 17 14. /` c o
In issuing this permit the State of North Carolina certifies that 0 5U � —0-1) d V
this project is consistent with the North Carolina Coastal application fee �C
Management Program.