47879_ANDERSON, KEN & SUSAN_20070501

^AMA / DREDGE & FILL
GENERAL PERMIT Previous per I
lYNew .—Modification ❑Complete Reissue ❑Partial /eissue 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 I SA NCAC
r t54rules attached.
Applicant Name n 941V S..Project Location: County . 1 ,, i /
i r.
Address 42 Street Address/ State Road/ Lot #(s)f� ,
City i .t l li `�f'�i� to ZIPo—, .
Phone # Fax # () Subdivision 0 gf1
Authorized Agent City ZIP C�
❑ CW XEW �TA ❑ ES ❑ PTS Phone # ��) — �' River Basin ({) p� 1i{
Affected'
OEA ElHHF ❑ IH ElUBA El N/A " ,
AEC(s): Adj. Wtr. Body na man unkn
❑ PWS: ❑FQ - r,.
ORW: yes /no., PNA yes //nZ) Crit.Hab. yes / Closest Maj. Wtr. Body -
no`
Type of Project/ Activity
(Scale: )
Pier (dock) length
Platform(s)
Finger piers)
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore
max distance offshore
Basin, channel -
cubic yards�-
Boat ramp t V;
Boathou /V-trlfti�
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes
Sandbags: not sure yes In 1'' \t
Moratorium: n/a yesPhotos: -�
Waiver Attached:
A building permit may be required by: �� • ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
�.tSAN Nv�it�Frr
Agent Appli�ca'ni, Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Rover File Name