33508_BIESECER, GARY_20030129

ACAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
ANew ❑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 I SA NCAC /
71Rules attached_
Applicant Name. ::
Address
11
City ; T11(!A % .,PQ" State \ICJ ZIP o Z
Project Location: County 'b1:LA. b SVJ'1C)�-
Street Address/ State Road/ Lot #(s) ) 2 (P
5All k;-,t' �'
Phone,#
Fax# Subdivision
AutFlonzed Agent kR Z
City
ZIP
ED CW
T�EW >
` �QPTA ` ES ❑ PTS
20�. hone,# ( (g)Co c�9 +� (�
River Basin L %& M V?, e-r
Affected. El OEA
AEC(s):
❑ HHF
❑ IH ❑ USA. ❑ WA
Adj. Wtr. Body fli
(nat mama nkn)
❑ PWS:
❑FC:
�_ I
ORW: yes'/ `C%
PNA
yes / no Crit. Hab.
yes / no Closest Maj. Wtr. Body
W
Type _of Project/ Activity U �cUV CN'c�A { t C �C b fl c k1 w� iVC'� 1
(Scale:
Pier (dock) length
FF T% I i
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ oatlift I Z: X 12,
Beach Bulldozing
Other
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r ompliance statement on backof permit
IssuingDate�
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Check #
Local Planningjunsdiction