58730_RABOURN, CLIFFORD_20111209

!=_'-CAMA / ❑ DREDGE & FILL
. Al
I
.. GENE RA L PERMIT
-`
Previous permit #.
-New edification ❑Complete Reissue ❑Partial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and
Natural Resources
) r.,/
° f,
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
6' �
�^ �y
Applicant Name !fib } (,
Project Location:
ules attached.
County v
Address CV'�" R�
Street Address/ State Road/ Lot #(s)
�
City ;;�dd yy ZIP 'P% 1
�- State
P'
Yl k y
T ! -AK
Phone # (_ 1 f 1 Fax # (o �) �/e
Subdivisioniji..,i7'
y ! /AI't11P
Authorized Agent Cl IG/l�
City 1
ZIP
p CW ❑ EW ❑ PTA ES ❑ PTS
Phone # ( )
River Basin��ff°
Affected
❑ OEA ❑ El HHF ❑ IH UBA N/A
AEC(s):
Adj. Wtr. Body
{^
FA��,$.�� I/V�
��/man /unkn)
❑ PWS: ❑FC:
Closest Maj. Wtr.
Body—
ORW: yes / no PNA yes /ano Crit.Hab. yes / not
Type of Project/ Activity
Pier (dock) I
Platf
Fing
Groi
Bulk
Basii
Boat
Boat
Bea(
Othr
Shor
SAV
Sanc
Mor
Phoi
Wain
(Scale..
)
��-
i length
number
LT-
- �.
-
I
r
i
--�-' i - -
fen
- - -= -
I
� � � 4 �r_
yl
___--_;__ -L
- L
---'- -- -
--_
--
I I
_
' it
o
I ---
r
---
gth
iprapI
--
,avddstancel offshore i _
max distance offshore _- :__._i __. _
channel
I_
T
I l
-. - -
/-�--
i-
� �
i.
-
-�.
r
-
—t
'
'-
cubic yards
ram
r
�1
souse/ Boatlift
77-
j
-; Bulldozing
rA 42
tv -
-
- -
-
�}kp�
u
:line Length IV
-
not s yes no
gags: not sure yesT
torium: n/a yesL
Ds:e no
ar Attarhed• ve
Fflt-
A-�.
-- -
- . ---- --'
'---
-
-
I
---
-
-
r
A building permit may be required by: F C1 U AJt 1
Notes/ Special Conditions
T 3'��`�.-ltm-�
Agent o�Applicant,Printed Name
Signature Please read compliance statement on back of permit
❑ See note on back regarding River Basin rules.
8l-
Local Planningf urisdiction Rover File Name
Application Fee(s)
Check #