40150_BASNETT, GEORGE_20041223 (2)

XCAMA / XbREDGE & FILL ly © 40150,6
GENERAL PERMIT Previous permit#
�QVew DModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As aUth/orized 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 15A NCAC e- —Attached.7 �7 �d�a5 ! &-7 � - ( 1,60
Rules
Applicant Name �OQ���_jZ_ Project Location: County_PtP
Address (3C_�r'� Street Address/ State Road/ Lot #(s) 4�
City State�� ZIP�OG� 7�
Phone # (�•��ax # () Subdivision 7t>
Authorized Agent Ci ZIP Zi7�
❑ CW EW TA CtiESi ❑ PTS Phone # (_) River Basin
Affected n OEA ❑ HHF ❑ IH El USA N/A
AEC(s): Adj. Wtr. Body F't Cat, 4JtZC� (nat /�/uni<n)
❑ PWS: ❑FC:
ORW: yes / KO PNA yes / Crit. Hab. yes / Closest Maj. Wtr. Body
Type of Project/ Activity
c5WOW � S (Scale: )
Pier (dock) length -
Platform(s)
Finger pier(s) XJID We-V� � :54A u �, L
Groin length 017
number
ulkhe Riprap length j5
avg distance offshore
max distance offshore g_
Basin, channel
cubic yards___
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
�pC RCJc�
Other r���
Cu QOLO
Shoreline Length /
SAY; not sure yes no
II
\t4
�'�AE
Sandbags: not sure yes ID—V A 1oR-A-4 \j.�, A�-,,,tY---D R1p RA-P Tv S—(jAuZZ
Moratorium: n/ yes no
Photos: yes
Waiver Attached: yes
Nti1•�z ScQ'['[� (,�v "" � z14-f? U� r?.. — � po
A building permit may be required by: PAQ5 c::—� Q ,- See note on back regarding River Basin rules.
Notes/ Special Conditions
�0 C K S�
Agent or App' ant Printed Nam
Signature
Signature 4*'*Pl as read compliance statement on back of permit ** Issuing Date Expiration Date
ILA
---� Local P annin urisdiction Rover File Name
3.1i,ation F e(s) Check #� g)