38862_BRAXTON, C L_20040614 (2)

& FILL �Icy �FERAL PERMITModification OComplete Reissue ❑Partial Reissue Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC t
Applicant Name ; ' • < '' (a k4.C..,
Address a"j c, ell a, if , h i n A 1 c Fri
-.;
City-f•k,a State IJe ZIP ?9430
Phone # (' c•?) '-- 21 340 Fax # (_ )
Authorized Agent Cole
Affected ❑ CW 0 EW ❑ PTA ❑ ES CD PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: (yes / no PNA yes / tno' Crit. Hab. yes / no
Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision ' t' ; r (n, �{ r-*
City ZIP
Phone # (_) River Basin 4 > r'd
Adj. Wtr. Body ima.r, wr d'eav5ow t (nat Aan /unkn)
Closest Maj. Wtr. Body SK� •.� t�+ s^
Type of Project/ Activity
Pier(dock)length
(Scale: 41L,—L )
Platform(s)—r--
F.
a-
Fingerpier(s)
I
_. __.
r
L -
- -
-
Groin length
number
Bulkhead/ Riprap length w
f
avg distance offshore ZI
i
' -
i
f
i
-
-
max distance offshore _.....
—
i
L
1-�
�t�
—
y
Basin, channel '�7t, i
F
T-
i
cubicyards
--- —
-
{
-
--
Boat ramp
t
t
i
--•
— - r --
Boathouse/ Boatlift
e
i
i
�. i�'si ,*!�. ���
�- i
, .. f-�-
(141LtiIC✓L'�
r
,
t , f 1
x--.r` 1
i - -.. �
- I ✓f , !t .
Beach Bulldozing
Other
Shoreline Length
7 `
i--
SAV: not sure
yes
4.°/,'
Sandbags: not sure
yes
Cno.-{
Moratorium: n/a
yes
no
j. 1--
Photos:
no
no
Waiver Attached:
yes
6�
A building permit may be required by: ror. ;t; ! /c ( F14 f., s,
Notes/ Special Conditions' r:
s+(- M•'1 �f{ir'r t.r�
�rJ jar'i,. M L+I �' y'� .l i l a i v�� r•%i4 {" q � of %I
Agent or ApCplicant rri'nted Name
Signature 's Please read compliance statement on back of permit **
vc
(�, ..)f+'t, (, ft"'d
❑l See note on back regarding RiverBasinrules.
41
Permit Officers Signature
¢PYt.`f 7iiqty' t
Issuing Date Expiration Date
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