10796_General Permit_19920619

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CAMA AND DREDGE AND FILL
GENERAL
a� Fl
a.PERMIT�.. 6
as authorized by the State of North Carolina �'CP�
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC -7 k / 13, b
Applicant Name `� Phone Number (�% % 6, k t/- S
Address
City State Zip
Project Location ( ounty, State Road Water Body, etc.)
/Y, -.,e- i,, , � ., . � , f Lr. 'te r +Qc t X , - r , /�
Type of Project Activity
PROJECT DESCRIPTION SKETCH M, (SCALE:
�w d�
Pier (dock) length
Groin length,
numbed
Bulkhead length
max. distance offshore
rz� r �
Basin, channel dimensions
10,
cubic yards
Boat ramp dimensions
Other /J
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.
4, iA
issuing date
applicant's signature
permit officer's signature
expiration date
attachments /�/ --// C
UC>U J* 5
application fee. � T' 2 � / r

PER-OTTO-HAGEN NCDL 34507137 7299
D. N. HAGEN NCDL 237950
PH. 919-544-7122
1129 LITTLE CREEK RD. 9 19 �Z 6666=46134
DURHAM, NC 27713 531
i
PAY THE ry I $ G� a�
ORDERER OF f� p J f./
/�JT D<L/� DOLLARS
C Central Carolina Bank
and Tnur Company 134
Durham, North Carolina 27702
MEMO
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