45654_KORUPP, CAROLE & RICHARD_20060629

CAMA / ❑ DREDGE & FILL 1 e
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue g 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
❑ Rules attached.
Applicant Name
Address
r�
City _-
State
ZIP„/ `! 1
Phone # ( ) -
Fax # ( )
Authorized Agent
Affected ❑ CW
O EW PTA ❑ ES
❑ PTS
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA
❑ N/A
❑ PWS:
❑FC:
ORW: yes / no
PNA yes / no Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP /
Phone # O River Basin
Adj. Wtr. Body (nat /ma n unkn
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: )
_
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ itiprap length
avg distance offshore
max distance offshore
Basin, channel
r
._ •J
„
:I
4
i
i
_
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other_
-
t
-
— L
Shoreline Length I
SAV: not sure yes no .�-
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
-
(,A jf ,!
See note
j
on back regarding River Basin rules.
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Permit Officer's Signature
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name
Application Fee(s) , Check #