55176_RIVERSEDGE COMMUNITY ASSOCIATION_20100506 (3)

RECEIVE
AMA / ❑ DREDGE & FILL � � � � � ��
ENTtate
L PERMIT Previous permit #
WC4ewation ❑Complete Reissue ❑49PLAUP, Date previous permit issued
As authorized byNorth Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental corffQa4ffWjjv 15A NCAC
®'Rules attached.
Applicant Name Rkta ir'se, aA,
Address � d$ 5 r;,ci� _ ►V t� Su, it 400
Cityr State � A ZIP D 3' i•
Phone # (23a) I1SS'a�1 W Fax # ()
Authorized Agent
Affected ❑ CW EW IKPTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
❑ PWS: ❑ FC:
ORW: yes /lh�o, PNA yes / I Crit.Hab. yes / no
Type of Project/ Activity—r� rz a w , a _ I
iir 5
Pier ( !
qF' atf
Finge
Groi
Bulk
Basin
Boat
Boat
Beac
Othe
Shor
SAV:
Sand
Mo
Phot
a Wai
Project Location_ County 0c.,s f, 4�-,c k-
Street Addressl State Road/ Lot #(s) S(Z § 3
Subdivision )ZVc-aS f- 4"I'A
City N'o�JoLk ZIP ';k1q.S'14
Phone # (_ ] VIA River Basin 3G
Adj. Wtr. Body tr'u-t.'.11- - k So,: O k-atA man /unkn)
Closest Maj. Wtr_ Body , 4, i- k So v ✓`
+ - "A_2
,Aciy 16' RAC
(Scale: ; = Lt0 )
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max distance offshore
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bags: not sure yes
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A building permit may be required by: (' , y . 11 L k. ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions H. 1r 00 . ff",nL5a-t) 3 'As 1, 914 X+ S'}•��+ 15 3 S �a'f :.r� : 3�
Sr
Agent or;' plicant P ted N"e
** Please ria&compliance statement on back of permit **
Application Fee(s) Check #
rermit Urncer s zignazure
Issuing Date
j ^o Li 1 Expiraationn'�Date
Jirj�
Local Planningjurisdietion Rover File Name