36712_KAFER, CHARLES WILLIAM_20031201

LAMA / DREDGE & FILL N Q 3 6 l - g —(
ENE ESL PERMIT Previous permit #
New Modification —Complete Reissue -Partial Reissue Date is permit previous p p sued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Re urces Commission in an area of environmental concern pursuant to 15A NCAC
-`Rules attached.
Applicant Nam Project Location: CountyAt
Address r
Street Address/ State Road/ Lot #(s)
-
T�� � t
City State ZIP g
�
Phone # ) 3 Fax # (_) Subdivision
Authorized Agent
Affected D CW
AEC(s): "J OEA
O PWS:
ORW: yes / no
[)ETA
❑HHF ❑1H
❑ FC:
PNA yes / P'o
Type of Project/ Activity
Pier (dock) length
Platform(s) J Iy. u
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other 1
Shoreline Length I
SAM not sure yes no
Sandbags: not sure yes o
Moratorium: n/a yes o
Photos: yes
Waiver Attached: yes
A building permit may be required by:
Notes/ Special Conditions _11
Agent or Wicant Vinted Name
❑ ES ❑ PTS
n UBA D N/A
Crit. Hab. yes / no
City�6�—`'�S �-�S ZIP
Phone # ( ) River Basin
Adj. Wtr. Body nat man unkn
Closest Maj. Wtr. Body
Scale:
t i III-40
I
• , K-Q,-
Vuk
` ❑ See note on back regarding River Basin rules.
Signatur "` Please read
Appli on Feels)
on back of Permit"
Check #
Rover File Name

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