51871_TANTUM, JOHN_20071121

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',6EDGE & FILL q'71 (:f--
,6AI\AA 1, 'R Previous permit # KEiDD
c;ENERAL PERMIT Date previous permit is
�ew L�Moclification —Complete Reissue DPartial Reissue 1�1
Carolina, Department of Environment and Natural Resources
ant to 15A NCAC_
As authorized by the State of North I �ules attacneo.
and the Coastal Resources Commission in anima of environmental concern pursu
Project Location: County
Applicant Name, Street Address/ State Road/ Lot #(s)
Addr s
State ZIP
City Subdivision
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Phone #
City �q ? I , ZIP
-u q Fax #
River Basin
Authorized Agent Phone #
r, J C__- ( r;�a�t\�Jman Junkn
W U4W- V�TA DES D PTS 6
Affected D OEA 0 ❑HHF 11 IH F1 UIBA Ej N/A Adj. Wtr. Body
AEC(s): D FC: Wtr. Body
0 Pws:____�" Closest Maj. Wtr Bo
_Crit�.Hab. �yes/ n�o��
PNA ��yes ) �no
2 Lc
ORW: yes / CO—)
fpe of Project/ Activity
Pier (dock) length --r
Platform(s)
Finger pier(s)
Groin length -------
number
Bulkhead/ Riprap length-
avg distance offshore
maxdistance offshore
Basin, channel
e'
cubic yards _
Boat ramp
Boathouse/ CBoa(ri�fj�
Beach Bulldozing
Other
Shoreline Length C
not sure yes
SAY:
gnod
Sandbags: not sure yes
Moratorium: n/a yes
Photos:
Waiver Attached: es-1) no
Q_V
A building permit may be required by
C
Notes/ Special Cor�ditions , �A 1
-1)
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aa_eet or Applkcant rr,"t,.,X3
statement onack of permit"
dcomp�liancesta�
Signatur Please read compliance statement
�se read - Check #
(Scale- )"; TS,
See note on back regarding River Basin rules.
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Rover File Name
Planning Jurisdiction

Personal Account Information Redacted