42265_BARTLEY, LARRY_20050824 (2)

���►MA / KEDGE & FILL
PERMIT
ew ❑Modification ❑Complete Reissue
As authorized by the State of North Carolina, Department of
and the Coastal Resources Commission in an area of environn
C7 ► 0
Previous permit # i l /A
Reissue Date previous permit issued
and Natural Resources
n pursuant to I SA NCAC 4� -7 A4 i O
Rules attached.
Applicant Name rL Elm Project Location: County �1 ��.,1� � e"a 1"')7 `>
Address 1Z) �t / / �'? Z--S ___ _ Street Address/ State Road/ Lot #(s) S'2 / 2..c., �
State r-JC ZIP 2-7g2!
Phone # (g&�) '7,q 6 --'�'; j Fax # ( )
Authorized Agent 1
Affected ❑ CW ,211W APTA ^ES ,i!tTTS
AEC(s): ElOEA ❑ HHF ElIH ❑ UBA [IN/A
❑ PWS: ❑FC:
ORW: yes no PNA yes no Crit. Hab. yes / no
Subdivision
City /_ a�_� n� i . zip
Phone # ( ) River Basin-_ <j,�&,r^r I IZ.
Adj. Wtr. Body ,e SSW BUJ apt /man /unkn)
Closest Maj. Wtr. Body LC�-r��' (� Sc+ �' ''�✓�
Type of Project/ Activity 17-Z> /1451-40tG 4— e .31`0 Q T A/
1��i
c✓co7� vv��ra G� p= ,���3�f��/�+z_ Gc�Gr� LC-2�_.� (Scale:
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Rirap length
avg distance offshore__
max distance offshore _ �
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
r•
Shoreline Length !43D
SAV: not sure yes no
Sandbags: not sure . yes no
Moratorium: n/a yes S
Photos: yes no
Waiver Attached: yes no
Elm
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A building permit may be required by: "T`l (-y
�— See note on back regarding River Basin rules.
Notes/ Special Conditions /C/0-7- ;X�L /[y
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22-1-1
Agent or Appli nt Printed Name !
Signature "Pleas ead compliance stateme nback of permit *�
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Application Fees) "' Check #
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Issuing Date Expiration Date
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Local Plan ningJurisdiction I Rover File Name