HomeMy WebLinkAbout44650_DONAHOE, MARGARET_20060524CA A / J.r)RE.Q; GE & FILL / `` A 650
GENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue ❑Partial Reissue VDate 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 Ti • I' DO
® Rules attached.
Applicant Name A s C k
Address 2124 ;ye(S�or(-P,S
City J �t" C; �=- State_ OC. ZIP ; 7 O g
Phone # (15 Z) 339 - I S J Z Fax # ( )
r � .
Authorized Agent
Affected ❑ CW [(EW XPTA WS ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / io PNA yes / oQ, Crit. Hab. yes / 0
Type of Project/ Activity N 00 CA b v• l k� e^ .,/ Y e
Pier (dock) length
Plat
Fing
Gro
Elk
Basil
Boat
Boat
Beac
Oth4
Shor
SAV.
Sand
Mor.
Phot
Waiv
Project Location: County_ PAS au � i tg n
tc-
Street Address/ State Road/ Lot #(s) 2I 2 y
-, v , -,- -Z 9 .
Subdivision V 1 /-\ 5 I D�") H C r f--�
City e ki 2 ZIP D-1 of 0 "1
Phone # ( ) River Basin ?A5 Q ,, j p n ( -
Adj. Wtr. Body W a A m & JJ Ca w J -ty (nat an unkn)
Closest Maj. Wtr. Body -PPN5 0 �-,J 0-CA ^ �- � � W e
Woa
QTS )
pier(s)n length
offshoreber
avg distance
max distance •
■
■
■
■
■'
channel
cubic yards
ramp
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021"UM
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.-i Bulldozing
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dine Length
not sure yes t
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es
torium: C;> yes no
.
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A building permit may be required by: VR5 CL —, )-rk n�
Notes/ Special Conditions
� m �C
Agent or A i t Pri Name
Signature Pleasereadcompliancestatement onback o permits
ot,o� 9?,3y /
Application Fee(s) Check #
❑ See note on back regarding River Basin rules.
Permit Officer's Sign
7�o
Z g 2
Issuing Date Expiration Date
Local Planningjurisdiction Rover File Name