4678_ELLIS, EDDIE_20061103

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GENERAL PERMIT Previous permit #
56New ❑Modification [--]Complete 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 I /0 d
® Rules attached.
Applicant Name Fdd;t- E IV, 5 Project Location: County. C (' Cw e-v\
Address Io01 S�e;j-e Street Address/State Road/ Lot #(s) ;c,.,d of We54-
City (La e\ '!!r, state ge- ZIP 3-1603 NAY' --ex IL�;'A—
Phone # (gob ) �S A-.57 b 110 Fax # () Subdivision cex�i,"'.' Q tie S
Authorized Agent \n1w.-0no&AA-S City Kew 1&.iN ZIP
Affected ❑ Cw ❑ EW ElPTA ElES ❑ PTS Phone # ( ) River Basin 4'e" f
Body
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A `u-C.0 na
r. e c�sL i�.
❑ PWS: ❑FC: Adj. Wt
ORW: yes / no PNA yes 0 Cris Hab. yes / no Closest Maj. Wtr. Body Ke%'- 'L Uitt/`
Type of Project/ Activity q \Q W t' ; p ccr.pC'Lko_v�%= yyo
(Scale:
Pier (dock) length
Platform(s)
Finger piers)
Groin length
number
Bulkhead/ Riprap lengthU
) y D
avg distance offshore O r
max distance offshore
Basin, channel
cubic yards r
Boat ramp
Boathouse! Boatlift
Beach Bulldozing
Other J
Shoreline Length, /_"/ d
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes
Photos: yes no
WalverAttached: es no
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A building permit maybe required by: CMQP-V. See note on back regarding River Basin rules.
Notes/ Special Conditions /al:, (sqr—q \ 0.y,�war& of 0.ti.!,k d-0a-.5+',A 1�
or
daf, ure "Please read compliance statement on back ofpermit'r"°
411.1- 00 �!Q?'
Application Fee(s) Check #
Permit Officer's Signature
%/ 3- r3� ,4 -.3'-� E
Issuing Date Expiration Date
C,.,LV-1D-VN. C, x'11ou1A
Local Planningjurisdicdon Rover File Name

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