46042_WILLIS, BEN_20060705 (2)

AMA REDGE & FILL
EN
N9 46042
RAL PERMIT
New ❑Modification ❑Complete Reissue ❑Partial Reissue Previous permit #
N#
Date previOuer mit is�s�ue�d�
As authorized by the State of North Car olina,.Department of Environment and Natural Resources
and the Coastal Resources Commission
in n area of environmental concern pursuant to 15A NCAC
Applicant Name�fn f f
les atth d
uac.
Project Location: County,-�C/crr
Address 1�► LI&��.�,
Street Address/ State Road/ Lot #(s)_
A
City /`%C7 State (/hl"ZIP
-- _ -- --- -
Phone # ,
,') Fax #
.mil - -
Subdivision
6(`)
Authorized Agent. AA JoIrAt"
City
ZIP
Affected ❑ CW W TA ❑ ES ❑ PTS
❑
Phone # (_) _River Basin � Q
OEA ❑ HHF Cl IH ❑ UBA C7 N/A
AEC(s):
❑ Pws: ❑Fc:
1� y—
Ad Wtr. Body— O 60 �./d H at man unkn
ORW: yes /n PNA yes Ciao Crit. Hab. yes / no
Closest Maj. Wtr. Body
H
Type of Project/ Activity �(}
Pier (dock) length
Platform(s) i-r -
Finger pier(s)
Groin length
number
QgdhRipraplengthistance offshore_-
max distance offshore
Basin, channel
J
(Scale:/Vv )
I i i 1
— - —r--
-+ --4- L _
cubic yards
j
Boat ramp
Boathouse/ Boatlift
r
Beach Bulldozing`�-
Other
i I I
Shoreline Length -t-
V '-
SAM not sure yes
I � i
Sandbags! not sure yes -
Moratorium: n/a yes -t--
Photos: yes
Waiver Attached: yes
A building permit may be required by: n
Notes/ Special Conditions
Agent or Applicant Printed Name
❑ See note on back regarding River Basin rules.
►vl i reI�c, 4d df- 4,Al
Signature ' Please read compliance statement on back of permit*
Issuing Mt
I A
vG
/6
Md