49128_PARKS, LAWRENCE_20110629 (2)

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n CAMA / ❑DREDGE &FILL
8 �~
�. GENERAL PERMIT
Previous permit#
]New ❑Modification El Complete Reissue [-]Partial 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
,: ..
Applicant Name 'I"' � i s U ' { t:i f'/ S
Project Location:
Rues attached.
County
AddressAWN 1-A 4+y i%'- _ i' ` i .. `IV
Street Address/ State Road/ Lot #(s)
city, IM1 I-z: i-1 StateW, ZIP -
U 414 N .
Phone # (;1 3) Fax # (__) '
Subdivision r4l�
-
�,� ii
Authorized Agent `�� 1i R(. CASI kin lya ;7.1�' i? � t t+ „�;
_. i
City i i �f.1 i ;
''; �(' i !., ZIP
❑ Cw � � PTA ❑ ES ❑ PTS
Phone # (� i
) � s j River Basini `% i i <.
Affected
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
Adj. Wtr. Body
I (: I- t.e [ � i ir� ..nat man unkn
❑ PWS: ❑FC:
p "'
CIRW: yes no,, , PNA yes /I no Crit.Hab. yes J no
Closest Maj. Win Body
Type of Project/ Activity t '-
Pier (dock) length
Platform(s)' I �"
Finger pier(s) J_-
Groin length --
number
Bulkhead/ Piprap length t �I
avg distance offshore
max distance offshore 1 _._. _ :-
+
1
(Scale:
TTTTTT
l— } T
Basin, channel�r .�l!`4`t' .r +' y ,, Z , s (l , ;
cubic yards_
Boat ramp
Boathouse/ Boatlift
Wd
�ro i J
Beach Bulldozing
Other
_!mil
d
Shoreline Length
SAV: not sure yes
Sandbags: not sure - yes • :,.np
Moratoriums n_/a. yes .-no
/
Photos: Yam' - --'` ----- .
Waiver Attached: yes �R q
A building permit may be required by:jL-
Notes/ Special Conditions
AgQnt or plicant Printel Name
, Ck- t c,'�� A
Signature Please read compliance statement on back of permit �}
Application Fee(s) Check # v `�
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date ' I Expiration Date
Local Planningjurlsdiction `; Rover File Name