55192_DONALD POWELL_20100604

g0A MA REDGE &FILL✓L, PERMIT \ Previous permit # ew odification []Complete Reissue EPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources 1
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC ! /4 4
�} ,r� {� fes attached.
Applicant Name �1/���I��T""L``~,,U--_� �tjll� �� �' Project Location: County
Address /�4:.G I\ Street Address/ State Road/ Lot #(s) Ski 1217)
City U, ��J- �4�tate� ZIP 3 1 Q
Phone # (� 7 `J Fax # (_) Subdivision j,(�t/C VA/fP777 l/ ,1
Authorized Agent MSC CAM LSO City J� d�T?" ZIP
Affected ❑ CW W ` 4-PTA ❑ PTS Phone # ( ) River Basin
❑ OHHF ❑ lH UBA ❑ N/A 1
AEC () s : FA [IElAdj. Wtr. Body ��� �e6�L� (nat ma /unkn)
❑ PWS: ❑FC: i4t-7a'I�7 SDU�tJ�
Closest Maj. Wtr. Body
ORW: yes PNA yes / n Crit.Hab. yes / no
no
Type of Project/ Activity ~ p e, °rf YC�91 696 1 A
pwo j 'j/t= S. V l (Scale: I )
Pier ock) length
Platform(s) �4 I � - r—
Finger pier(s)
Groin length
number
4j:g> Riprap length
av distance offshore�—
max distance offshore I - -
I- Lt7
Basin, channel
cubic
yards
_ T-I
— - ---- -
Boat ramp
Boathousq B atl' I3 Ku
- - -
,, I
Beach Bulldozing
Other
i _ I
gth
of sure yes no
—
o4-1t sure yes no -
yes no
1 i
no Jol
ched: no __ -1 5�•.
n
n
Shoreline Le
SAV: n
Sandbags:
Moratorium:
Photos:
Waiver Atta
A building permit may be required by: WE
Notes/ Special Conditions
On
❑ See note on back regarding River Basin rules.
Si n to ! 4* Please read compliance statement on back of ermit **
g,
601,
Application Fee(s) Check #
Issuing ate �x iration Date
PqN
Local lanning�isdiction Rover rile Name