42407_BEERE, GEORGE_20050722 (2)

l_-�-6AIVIA / 1-1 DREDGE & FILL
N9 42407
GENERAL PERMIT`
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1,911ew _ ]Modification ❑Complete Reissue I JPartial Reissue
Previous permit #
Date previous permit issued /✓/
As authorized by the State of North Carolina, Department of Environment and Natural Resources 0 -7y� 1 1�
and the Coastal Resources Commission in an area of environmental concern pursuant
to I SA NCAC 1/
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Applicant Name _
❑ Rules attached.
Project Location: County
Address___ �L I C��` Gr f
Street Address/ State Road/ Lot #(s)
City--- �� ' -- State Iv ZIP�----
Phone # (-703)—a(��G30 Fax # (�)
Subdivision
Authorized Agent 'N� � `��' ` � _
Cit- ZIP
Affected 0 cW ❑ EW ❑ PTA E,�K' ❑ PTS
Phone # River Basin
❑OEA ❑HHF ❑IH ❑USA ❑ NIA
AEC(s);
Fn�� C^u��
Adj. Wtr. Body�� ( at man unkn
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body_
Type of Project/ Activity 6"� `"fi 16'� r o� � -
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
.f
E
khea Ripraplength�Q
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing '—
Other
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(Scale: /✓oiler
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Shoreline Length ! v
!ni
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SAV: not sure es no
y
/� AV
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Sandbags: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:
"'
��e note on back regarding River Basin rules.
Notes/ Special Conditions
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Agent or Applicant Printed Name
Signatu a Please read compl' nce statement on back of permit
Application Fee(s) Check #
Permit Of er'sSignature
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name