43626_STONE, JOHN & PHYLIS_20051201

' AMA / f DREDGE & FILL id ? 4 3 6 2 6 L
K.JGENERAL PERMIT Previous permit#
w 1Modification 11Complete Reissue I (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 'n an area of environmental concern pursuant to 15A NCAC 1
I s attached.
Applicant Name J-011 ✓t C�!►County
f' __- _ Project Location:
- -- — - f 1
Address _ (% _ Na Z e ( 6t1 - - Street Address/ State/ Road/ Lot #/(s) /
City..--- ,l�%Pt✓�o�fi State�C ZIP p� �U _. 0 , f 1A-Ir G c�
Phone # (_ ) �5ax # Subdivision
Authorized Agent _ City /(%(' �oV'4- ZIP s v
Affected W CIEW ?10TA LIFTS Phone # ( ) River Basin V Nik
11 OEA i 1 HHF I _l 1H I-1 UBA I I NIA
AEC(s): f l PWS:Adj. Wtr. Body U �u _fr cas (n�/man /unkn)
_ -_ f"1FC: �r� U
Closest Maj. Wtr. Body `p� � a`^
ORW ye i no 1'NA yes no Crit. Hab. yes / no i - -
Type of Project/ Activity u� iio r O G 1, 1,21
1 ►� �uri,�, `'► r (Scale:
Pier (dock) length -A pU
Platform(s) V t' if O CRY►
Fingerpier(s)
Groin length
number �t U
Bulkhead/ Riprap length
avg distance offshore
max distance offshore 4e
Basin, channel I I+Ay V I i
cubic yards"
p S
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other Cf 0
Shoreline Length _ 7/o0
� I I
SAV: not sure yes r j
Sandbags: not sure yes no
Moratorium: n/a yes r
Photos: yes
Waiver Attached: yes io J I I
A building permit may be required by: Ci9r r (G j - ] See note on back regar-ding River Basin rules.
Notes/ Special Conditions Oh \ f 1 •j G LA h Or-1 Zrc/ I/S (-` s
` or A.p 'cant Printed Name
Signature ** lease read compliance statement on back of permit'1
-- d U - - - 1063
Application Fee(s) Check #
Permit I r s Si natu e
Issuing Date E ir!).-n Date
Local Planning Jurisdiction Rover File Name

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SIGNED �u►'�. FORM 4003