44298_TOLSEN III, HUBERT G_20060216 (2)

,AKIA / F-1 DREDGE & FILL '
ENERAL PERMIT P vious permit#
ew [JModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources f j
and the Coastal Resources Commission in an area of environmental concern, pursuant to I SA NCAC i
ES�Rules attach cl,
Applicant Names (a��� -�' ""� Project Location: County _ 7/' t t<
4—
Address zx/' (o',4 3J. Street Address/ State Road/ Lot #(s)
City- State VC, ZIP —
Phone # (`� ) " cl{f )r Fax # () Subdivision
Authorized Agent — City i.J{`�I 1 "� `+'`t ZIP
CW [-;EW-0-PTA ❑ES ❑PTS Phone # ( ) River Basin
Affected )
ElOEA L HHF ❑-IH iJ UBA ❑ N/A }� / G AEC(s): Adj. Wtr. Body nat /man /unkn)
❑ PWS: ❑ FC:
D Closest Maj. Wtr. Body
ORW: yes / /rio RNA yes / no Crit. Hab. yes / no
Type of Project/ Activity T dy .j. `�� t /Y G t:r► f . j .ram - . 7 �' �.. ,.. r y�,f //r? ✓ f
(Scale:
T r }
Pier(dock)length (,> .X +�.) _ _-__.•_«_'_
Platform(s)-
Fingerpier(s)
Groin length-
4
number -a 4 41'A----
i
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel - - -
cubic yards i -r -i
Boat ram - — -
p;-
• -�-
Boathouse/ Boatlift - 11`
Beach Bulldozing Z--
Other,i• ✓"n Cx)r r ne—
`
Shoreline Length 2 i 0 —
SAM not sure yes eno)
Sandbags: not sure yes
Moratorium: n/a yes of `Y
Photos: yes no
Waiver Attached: yes o
A building permit may be required by: _
,,')
Notes/ Special Conditions {�<"✓ ^' f
1-4
Agent or Applicapt d Na e
Signature Please read compliance statement on back of permit
0o'.
Application Fee(s) Check #
❑ See note on back regardin River Basin rules.
y�D6
Issuing DatJ Ex irati n Date
rl -'.--A r a Y 0" / I J
Local Planning Jurisdiction Rover File Name

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