11391_General Permit_19930608

�O7�
f /
Fri 9
CAMA AND DREDGE AND FI
GENERAL ON'T 0 113-1
` JUN1'� 19Q 11'-V-
PERMIT
as authorized by the State of North Cai '"'""...... �
Department of Environment, Health, and Natural Resources and the CQasJal ResourcesCommission
in an area of environmental concern pursuant to 15 NCAC //r-0 Z V
Applicant Name
Address r
City (kZ-SJk
(1
Project Location Nounty, State Road, Water Body, etc.)""
I t J,
Type of Project Activity a v
Phone Number f 0 ; �/) U
State ./Lc Zip 7�
I ce Sx ��✓v k �Aw. i
� f
PROJECT DESCRIPTION SKETCH
Pier (dock) length
Groin length,
number
Bulkhead length
A
max. distance offshore I/
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
I
pit)
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 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.
(SCALE: ✓`1.() r,/ i )
x-171
E_1till a�'C�
In
applicant's signature
permit officer's signature
issuing date expiration date
attachments /1,�, y i )/-/, / I f U/ v
application fee