3807_SMITH, CLYDE_20040407

FROM Rid —A —Pest FAX NO. 125224(0�3{532 May. 14 2004 09:50AM P1
E i FILL
EfVER�1{.. PERM i'T Previous permit
_Com fete Reissue Pa rtiat-Reissue Date Previous permit �ssued��
h�INew !Modification P
As authorized by the State of North Carolina, Department of Environm,nc and Natural Resources ` (2. P O
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCRC ic' Rules attached.
Applicant Name C1 L. ?�.r — —'
Address —_Jo6 n�laf�6_�'•.. .. _
city KS State I'lG Zip
Phone # GLI) Z` �=� 5 _ Fax
Authorized Agent �t�i(—
Affected u CW X EW ;C"A -' ES - Pzs
AEC(s): iJ oEA rJ HNF 71H = USA WA
u PWS: CFC:
ORW: yes / ® PHA yes / q Cris Nab. yes / no
Project Location: Counq_a! 'c —. --• -
Street Address/ State Road/ Lot #(s)
-'ra vb�
Subdivision
Phone # ( ) _.._ River Basin d 14C 014-
Adj. Wtr. Body--.-r"-'-4n Ma l&Atc l bA .(� /unkn
Closest Maj. Wtr. Body • �-d _.... .
Type of Project/ Activity 7roair
(scale. A
Pier (dock) length
Platforms)
Fingerpier(s)
Groin length + - -
number — -' -- -r
Bulkhead/Riprapbngth— "�..� Ma►�I�lad.�_:[arlat r"T~�' ` . i.. ,
i
avg distance offshore—
max distance offshore pifo►i __- — _
Basin, channel....
cubic lards i+
r7
Boat ramp
Boathouse/'�J- •vncoutrcCl -.-3A
emri
Beach aulldoal^g?cam
other
Y Mrz —
I
$hovel"nee Lc�dr'• -- —� —r- -_. I
—
-- �
-
+T — + Imo, �
�7 i _
Sw. act, sure yes
SwAb461
hforatotium: cda
Yes
Waiver Attached: no ,^
A building may be required bar
Sea noes on bade regarding River
f3a5in rules.
perrnk
Noted special conditions �►ly i-wa
s(;0, aJ'.� �t
�4((
..c (otMr�rt.a f ^•v-t �F � r�F
� YY
1i16rk(Q U C4 Rf -Tr i>
Agent or Applicant Printed Name
' re �* p!� read compliance statement on back of permit's"
Ee Ap V —
Aoalicrtion Fee(s) Check#
s
—L �I a ;l `.,r .1 : ,. Y. `� . �•' ,�, :(3,/ - _ _
Issuing Date "on Dam
I�oed planning )utman Mover File Name

ERIC B. ELLIS
JASA M. ELLIS PH [phone] 2917
205 NOTTINGHAM DR.
MOREHEAD CITY, NC 28557 r
Date OJ 66-30/531
i._ Pay 'U, : � . � 133
a ter..
Dollars
;ST CITIZENS,33
�rII At antic Bea Bank 8 Trust Company �V
- y1 Atlantic Beach, N.C. 29512
Trust
www.firstcitizens.com
For._.
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00 13 1 7 4 48 780uNP
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