10547_General Permit_19920702

CAMA i
GENERA
Applicant Name
Address
City . I
9
10547 -b
as authorized bTythe :fate of \15rf!i Carola
Department of Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC l�(- r� C � r,
Bot` lL k '4f1 4- " t Pho e Number D
T
�i-;u. lei r;.
State
Zip
Project Location (County, State Road, Water Body etc.)
?_7c"
t�•l tit I�It.U_
Type of Project Activity
PROJECT DESCRIPTION
SKETCH
(SCALE: )
Pier length
x
(dock)
Groin length
en the
0 LA
N
number
number
(l
Bulkhead length
max. distance offshore
( �1 i
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other��r�
Ck
L
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any
violation of these terms may
imprisonment or civil action;
and void.
subject the permittee to a fine,
e
and may cause the permit to be-
1
/j a plicant'ssignature
come null
come
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.
issuing date
attachments I �4/✓�
application fee ��`
permit orricer's signature
expiration date