49977_WEST, KENT_20080218 (2)

- N•CAMA / ❑ DRE'D—SE & FILL,
GEN wodificationPERMIT Previous permit #
]New ❑Complete Reissue ❑Partial Reissue Date previous permit issued
A,
As authorized by the State of North Carolina, Department of Environment and Natural Resources )) ,,t
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC iw'- 1 �?(Irl
E Rules attached.
Applicant Name 1<1
Address mQ � Zk0j:—r--_��lf
City j,1 Z M !��/ t �--State J4/C ZIP
Phone # ("1 i' Fax # O
Authorized Agent''�'•4
Affected• CVV EW , K PTA ElES ❑ PTS
AEC(s): ❑ OEA ❑ HHF O IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes /not PNA yes / J°' Crit.Hab. yes /I
Type of Project/ Activity
Pier
Plata
Groi
Bulk
Basii
Boat
Boat
Bea(
Othi
Shot
SAY
Sanc
Mor
Phoi
Wail
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision cne !'h-17 t)
City ;i ZIP
Phone # ( ) River Basin
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A building permit may be required by: �h.!'J ❑ See note on back regarding River Basin rules.
Notes/
S
Agent or A41idnf Fri ted N
Signature "Please read compli nce statement on back of permit"
Cl J
Application Fee(s) Check #
Issuing Date 3 v f Expiration Date
Local Panning Jurisdiction Rover File Name