54678_RITTRELL, JUANITA RAY_20091002

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C!l-'AMA,/ ❑ DREDGE & FILL
CkMERAL PERMIT Previous permit #
), fete Reissue ❑Partial Reissue Date previous permit issued
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As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
ules attached.
Ali. Project Location: County
Applicant NameT�.j� f
Address i �'r -+ Street Address/ State Road/ Lot #(s)
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City li State 1 ZIP�3 f
Phone # O Fax # O Subdivision
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Authorized Agent 1 �j:�, Al -' l!�-# ` i'* i City ZIP
❑Svii C�FW E: PTA El ES [IPTs Phone # ( ) Rivpr Basin I
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body l T ��'1 l ( (`�' l�(nat /man /unkn)
AEC(s):
❑ PWS: ❑FC: —�
r. Closest Maj. Wtr. Body
ORW: yes / 60 PNA yes / �o } Crit.Hab. yes / no
Type of Project/ Activity
(Scale: Y )
Pier (dock) length *�iiA`11
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length_
distance offshore—
distance offshore_
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A building permit may be required by: I
Notes/ Special Conditions C )J
Y ❑ See note on back regarding River Basin
Agent or Applicant Printed Name Permit Officer's Signa ufe
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Signatu. e `\PleasQ read.com ian a statement on back of permit *� Issuing Da
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Rover File Name

Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
"Anticioated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
ternimpacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other.
Qnredge
❑ Fill ❑ Both ❑ Other
IV
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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