40257_FUTRELL, GLENN_20050114

AMA / L�R1VEDGE & FILL O i-4025'7
GENERAL PERMIT Previous permit#
NNeW ❑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
I kRules attached.
Applicant Name G i� EN&) L _ rUT R L- IL Project Location: County ��kA:�- L'' Ju!N ry�
Address sAi'l �ISlf j�lQ)11L� Street Address/ State Road/ Lot #(s) Tal*A &4'd p�
Cik?')T- L d State A) C ZIP `kor4,0 (S-d azw )
Phone # Fax # ( ) Subdivision `
Authorized Agent City_ ZIP
Affected ❑ CW NEW ' PTA ❑ ES ❑ PTS Phone # ( ) River Basin /b� S �,►� k oT�I�t
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body CkA-L-- (nat / nkn)
❑ PWS: ❑ FC: � ,c,
ORW: yes / PNA yes / Crit. Hab. yes / Closest Maj. Wtr. Body (�f(. ©4-r7f-i SQm-u -
Type of Project/ Activity /`'I ► N `T �✓ wwc -P FYCAW'Tr .4y Ti L-<,- C14OL'A-c —
(Scale: )
Pier (dock) length
Platform(s) A
Finger pier(s) NOle`1m � R© If-71W
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel x /„2G'O �( �©
rj'wi1e, . _� cvew AAe-+
cu is yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing Other tr�elt)iC%/R/S 44-
Shoreline Length 410co
SAM not sure yes
Sandbags: not sure yes 6 to
Moratorium: n/a yes ® , S
Photos: yes no 1
Waiver Attached: yes no
A building permit may be required by: ...—
Notes/ Special Conditions
A 0 -
r-
Agent or Applicant d ame
rU TA-ec-,
. See note on back regarding River Basin rules.
P a��L S Cc) � � S 1 T'e-
-2/ erTGdiC/ow is r.eei
Sign ure ease re d co pliance tatement on back of permit / Is ing Da Expirati n Date
ApplicationFee(s) Check# Local Planning Jurisdiction Rover File Name