53683_SAYLOR, SCOTT_20090522

i�MA / l�,-1111AREDGE & FILL NU 5368 'a,
GENERAL PERMIT Previous permit #
eew ❑Modification Complete Reissue CPartial 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 1 '
q.
�. es attached.
Applicant Name Project Location: County
Addres Street Address/ State Road/ Lot #(s)_
City nnState ZIP
Phone # P-0() Subdivision
Authorized Agent _ City — ZIP
Affected C1 Cw l ES ❑ PTS Phone #4PAiveZrsin
IJ OEA I I HHF IH 1 UBA [-IN/A
AEC(s):Adj. Wtr-. Body nat/ /u
an nlq))
Cl Pw FIFC:QRYd: yes / o PNA yes / o rit.Hab. yes / no Closest Maj. Wtr. Body_ --
.a. _ I
Type of Project/ Activity M2 1 n,2Arff_
(Scale: I� )
1 V
V
I� w
Pier (dock) length_
Platform(s)__
Finger pier(s)_ - - — — --
Groin length
number_------,--, _
Bulkhead/ Riprap length
avg distance offshore_
max distance
offshore
Basin, channel
cubic yards C
Boat ramp
Boathouse/ Boatlift _
Beach Bulldozing
Other
5',.Yrnf\- V
'V
Shoreline Length
5_.
SAV: not sure
yes
Sandbags: not sure
yes o
Moratorium: n/a
yes o
Photos:
yes no
Waiver Attached:
yes no
A building permit may be required by:
s
LIM
r _ _ /1 I, Ser no o �ck r1garding River Basin rules.
E -
Applicant Printpa-M)me
Signature ** P aad compliance statement on back of permit Issuing Date y ' E (piration Dot
c Check# LocalPlanning4isionRover File Name
Application Fee(s)