31794_MAYNARD, BILLY R_20020927 (2)

�9"CAMA / MDREDGE & FILL �` e
GENERAL PERMIT Previous permit#
C New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued ,-!fIA
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 5A NCAC C: ,'�:✓'�'
Rules attached.
Applicant Name 1MYOA A
Address l . � fr f,`y: 9-1 u +�
City �OC �- State A) Z' ZIP -V 79-68
Phone # (:;a ) 03 9 -4318 Fax # (_) A11A
Authorized Agent At
Affected ❑ CW XEW ; PTA [kES ❑ PTS
AEC(s): ❑ OEA ElHHF ElIH ❑ UBA ElN/A
❑ PWS: ❑FC:
ORW: yes / Cjl PNA yes / no Crit. Hab. yes / no
Project Location: County CUR r TO €'•K
Street Address/ State Road/ Lot #(s)
Subdivision J3,XA Y t,AlAD/X)�'
CityA4 Qom/ ZIP o't7958
Phone # 31A River PBasin A5G'Uo7�AJP,_
Adj. Wtr. Body i U LI .5 A ;�,:iat9 /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity ("' 610 5y% o Ctr c*`
1444775Rbt►egAD Or A°$3J )5)yS- AJ6 / it o #"J (Scale: A).J'S )
Pier
Platf
Finge
Groin
Bulk
Basin
Boat
Boat
Beac
Othe
Shor
SAM
Sand
Mora
Phot
Waiv
dock) length
orm(s)
r pier(s)_.
length
head/R'
house/
�
-
)-
I
X_
T �I
.
r 1
number
!
I j
_
�T_,
rff"!en h lt3L?=_
d
avgdistance offshore
max distance offshore
- �-
T i—� J- I -
i I� 1 I
}(�
channel
��
-�
i
—C �_ l
r i
-
cubic yards
ram
Boatlift
�--`,
I
TF
h Bulldozing
r
I
i
I}
eline Length O
not sure es
bags: not sure yes
torium: n/a yes no
os: ��1� e no
�_.
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nr Attanc�+rl• vae /nnl
u
A building permit may be required by: 4: ( Ali i-U C K ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
F
Signature * Please read compirnce statement on back of permit"
Application Fee(s) Check #
Permit Officer's Signature 1 5,
Issuing Date Expiration Date
C" t 'k 0- r 7 L) C, K Rom'y z; , %";+f Ci j .� 614. A
Local PlanningJurisdiction Rover File Name