57396_SHERRILL, DEBBIE_20110630 (2)

MCAMA / 1:1 DREDGE & FILL
GXNERAL PERMIT Previous permit #
N&ew ElModification OComplete Reissue El Partial Reissue Date previous permit issued
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.
MR , 77,
Applicant N 4 Project Location: County 0-11fel Maine a—h She
vt,
Address �� .10� 1�� /. .1 -- 4 - .. , - �r 1 11 1 Street Address/ State Road/ Lot #(s)
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Ciryt Q, State
Phone # (100 !VjY1 crW Fax- # c
Authorized Agent Ti?4(,, V4
Affected lam. CW WEW :0 PTA El ES (-1 PTS
AEC(s): E3 OEA El HHF El 1H 0 USA El N/A
0 PWS: 0 FC:
ORW: yes/ 1PNA yes/ no Crit.Hab. yes no
&n
Subdivision
City zip
Phone# River Basin
Adj. Wtr. Body_15-;=.(nat'f6iiR'Vunkn
Closest Maj. Wtr. Body w-w
ier(s)
ngth
MEN
number
thead/ Riprap length
avg distance offshore
max distance offshore_
n,channel
cubic yards
ramp
thouse/ Boatlift
MEN
h Build zin
MEN
PON
line Length
not sure yes Cno.
FAIM21.41 a NOWEN
mom on
'bags: not sure yes
5n
61 TOFU W96WIN
w 0 MEN M
No
'i17rA, N N
orium: n/a yes
er Attached:
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Jeq,
�'A or Applicant Pri4ted Name
Signature ,,4*�lefa4eki.�om6iadc '—'ment on back of permit
Application Fee(s) Check #
Pe Officer's
Issuing Date
Planning Jurisdiction