40259_BUREK, REGIS AND LYNDA_20050302 (2)

S�ICAMA / XDREDGE & FILL'
GENERAL PERMIT Previous permit#
RJ�ew ❑Modification ❑Complete Reissue ❑Partial Reissue 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 15A NCAC ��
J?Rules attached.
Applicant Name S &A Lind* ✓f. R -
Address- �
City C hade s4ordit State'3, V ZIP 'a54 14
Phone # (Z) Lya1- 02 Fax # (}
Authorized Agent tkt d J2 1 1�� M rn2taa�o ��ss
Affected ❑ CW ElEW IOTA DES Nt TS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes /o PNA Q/ non Crit. Hab. yes
Project Location: County
Street Address/ State Road/ Lot #(s) mn, r ;
Subdivision i1 s
City &s,--44rn .Shorts ZIP'0779��
Phone # ( ) River Basin TASaLIA0TA -1 -
Adj. Wtr. Body CAHA! 'b C►>u L / ar an nkn
Closest Maj. Wtr. Body—
0 a r u c 1< C�xa ns�
.
IType of Project/ Activity f*C kW A-h On t� rVIPaN, rA rkd ( rA,1caJ
Pier (dock) length
Finger piers)
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore -
max distance offshore
i
;s IRV.MJI ,14A4.
Shoreline Length
SAV: not sure
yes noT
Sandbags: not sure
yes prp�
Moratorium: nry
yes no ff
Photos:
yes no
Waiver Attached:
yes �nQ�
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
e �l�nAa
Signature Please read compliance sthtementon backof permit
100- QQ-
Application Fee(s) Check#
(Scale: 1NTS )
1—
❑ See note on back regarding River Basin rules.
e/ Ae ?A.rele/ e.� e'"'y
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Issuing Date° lExpiration Date
Local Planning Jurisdiction Rover File Name