59948_SAMS, JOHN_20120809 (2)

ICAMA / ❑ DREDGE & FILL / V/ No. 59948 fi
GENfpA PERMIT REC,jVED Previous permit#
New dification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
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As authorized by the State of North Carolina, Department of Environment and Natural Resources2012
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC.
J Rules attached.
Applicant Name 170NAr Project Location: County t'b 1 JA,° P AZ
Address .Q lq Q U ,% nj ST Street Address/ State Road/ Lot #(s)
City 1QI<1State zlP
Phone # (D p ry, d &15 Fax # ( ) Subdivision- rt.�
Authorized Agent City -,�, i6,7N-Are', f ; zip T 2U
❑ CW ❑ EW**H
TA ❑ ES *TS Phone # ( ) River Basin f'�-'�i' 9 Z'� S�i�`
Affected ❑ OEA 1-1HHF ElUBA ❑ N/A
AEC(s): Adj. Wtr. Body CANAL 7' P `?ile-, f f "k '(nat / a unkn)
❑ PWS: ❑ FC:
ORW: yes / PNA yes / no" Crit.Hab. yes / ?nd'•
Closest Maj. Wtr. Body9 `� N
Type of Project/ Activity d , ' M U. ' . i fi r
(Scale: � )
Pier (dock) length
Platform(s)-
y' aY�
Finger pier(s) !
Groin length g6r:. `
number
13 lih ad/ Riprap length l
avg distance offshore t J
max distance offshore -
Basin, channel - - - -- - ----- ---
cubic yards
Boat ramp
f
Boathouse/ Boatlift
Iv ��
Beach Bulldozing -. - -
Other
Shoreline Length
SAV: not sure yes
y - - --
Sandbags: not sure yes n �
Moratorium: n/a yes A F>
Photos: (9 no
Waiver Attached: yes
A building permit may be required by: ia. y{' Ni "11ie- V41 See note on back regarding River Basin rules.
Notes/ Special Conditions
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Agent or Applicant Printeid Name
Signature r Please read compliance statement on back of permitAl
Application Fee(s) Check
Permit Officer's
Issuing Date Expirafior [Date
Local PlanningJurisdiction Rover File Name