59365_SARDEN, MATHEW_20111114

LAMA / —i DREDGE & FILL N? 5 9 3 6 r
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L PERMIT Previous permit #
!Flew ation 'Complete Reissue Partial Reissue Date previous permit issued
As authorized by tNor�KCarolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC j
��. Afkuless attar
Applicant Name � � i �v" I Project Location: County
Address '—A X r Street Addres sl Stag Road/ Lot-#(s)(s)
ity_
Phone # A y~Fay
Authorized Agent
Affected -' Cw ') E" A
AEC(s): ❑ OEA HHF ❑ IH
❑ PWS: ❑
ORW: yes / (np PNA yes /
Type of Project/ Activity ___lk) a,
Pier (dock) length _ —�j J
Platform(s)_I o, X1 I
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel _
cubic yards
Boat ramp
Boathous oatli
Beach Build ^rng
Other Q Zm a .-A
❑ USA D N/A
Crit.Hab. yes / no
city t�IW !�:k(: J 1-V )A-11 U ZIP
Phone # 0-1 River Bash
Adj. Wtr. Body
Closest Maj. Wtr. Body J
r
J ..✓ ��
t (Scale: )
`L
l i -
Shoreline Length
SAV: not sure
yes
Sandbags: not sure
yesMoratorium:
n/a
yesPhotos:
Lno
yesWaiver
Attached:
yes
A building permit may be require y:!
Notes/ Special Conditions
Agen or plica Printed ame
Signature read compliance statement on back of per/mit
—T
Application Fee(s) Check #
Local
Name