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Home My WebLink About43295_LEWIS, MARK_20060109N0. 43295 qN MAGE &FILLERAL PERMIT Previous permit # ❑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 Rubes attached. Applicant Name M Aa XL Project Location: County Q tLx i -a- Address L G v-ZS Street Address/ State Road/ Lot #(s) Ciry__ r-� Q� c A StateO L ZIP 7f3i 3 1 Z S IP f — Phone # S 10) Z"1�Z (��" Fax # (--) Subdivision Authorized Agent City 5 u Atoms ElCW "SSA ElES ❑ "S Phone # ( ) River Basin yL�vl� ti C Q Affected ❑ OEA p HF ❑ IH ❑ UBA ❑ N/A AEC(s): Adj. Wtr. Body_�� _v.�_1✓ (nat Q—�unkn) ❑ PWS: Or-C. t YLT ✓ `� Closest Maj. Wtr. Body � t "✓ ORW: yes no PNA yes / 4 io Crit. Hab. yes / no Type of Project/ Activity i2 t Lr. c_ rnBZrJ-i%+J �z� i_T,, (Scale- Pier (dock) length Q, K 1 y (0 --- Platform(s) Finger pier(s) Groin length number Bulkhead/ Riprap length avg distance offshore max distance offshore Basin, channel Z.0 x cubic yards 2, O 2"r3 Boat ramp Jy Boathouse/ Boadift- Beach Bulldozing Other Shoreline Length Zj 1 J + -- - SAM not sure yes no .- - ----- -- Sandbags: not sure yes l Zrr x y " Moratorium: n/a yes - tan� I 1_ Photos: yes -- Waiver Attached: yes - ---- — - A building permit may be required by: �J ;J5 l� �� -� �j ❑ See note on back regarding ^^River Basin rules. Notes/ Special Conditions S H A L L N' 1 Cx L � c 1 +-1 as v✓ � ► c rL �, \)C L� � tiv �" S nt tom' Ageor Applicant Printed Nam , Pe itOffuer'sSignature Signature *' Please read compliance statement on back of permit ** Issuing Date h 1-Pi1 C'\..1-,i .i r n -9 �l Expiration Date