43541_MILLER, KENNETH_20060111

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DREC7GE & FILL k(, nCyA/ C r� J .3�5�41
(`;NE��� PERMIi Previous permit # '
Ci�lew C�,!`lodifiztsn ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by �ie State of North Carolina, Department of Environment and Natural Resources f
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Q /�U
)� [Rules attached.
Applicant Name GCLr / Project Location: County
,...
Address � , •� : ����» Street Address/ State Road/ Lot #G(s)
City ✓ r.�a t.vU State P �k p *� Io
Phone # OJ—)--)-7
y'r'"�r0y
Fax # ( )
Subdivision —'
Authorized Agent
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City �� y io
ZIP
❑ CW
CAW
[9,PA [HE'S ❑ PTS
Phone # (_)
River Basin 2✓e'" �-
Affected
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body 4,
1`� `�e'� at Iman unkn
❑ PWS:
ORW: /
PNA
❑ FC:
/ no Crit. Hab. / no
Closest Maj. Wtr. Body
yes
yes yes
Type of Project/ Activity
Pier (dock) length
Platform(,)
Finger pier(s)
Groin length
number -
/ �y-�����'/'4�. •� � X/ d I � ! Y?/C!- �J G� � '� � � I d�r/D/YN QYIY G
(Scale:
Bulkhead/ Riprap length
avg distance offshore
I I I
max distance offshore-
t—
Basin, channel
---
-e
ti
- �
cubic yards
Boat ramp
1
Boathouse/ oatlif JS �i J p
_
.-r-
I —i N
i-j '•
Beach Bulldozing
;__-' _- _. --
r
�T-� - - - - ----
—i—
{
Other
--
I
,
�T +act
Shoreline Length
SAV not sure yes no
Sandbags:
- -- -
I�f)_�_ — -
>,
I.L.
not sure yes o
Moratorium: n/a yes no
Photos: yes. o
M©r�ho4i f D1t
Waiver Attached: yes n
._.___:___ __
( °
_._.
❑
_.__
A building permit may be required
by: y "'
r "
S e note on back regarding River Basin rules.
Notes/ Special Conditions
(�'X o
f
Agent or Applicant Printed
Signatur Please read compliance statement on back of e
P
Application Fee(s) Check #
Permit Officer's Signature-
) //_ ptb %l-
Issuing Date Expiration Date
rA,-Wo -6, Y11 ) d %%-e
Local Planning Jurisdiction Rover File Name

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