41252_WIESNER, JUDY & WIESNER, A. DONALD_20050614 (2)

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/ ❑DREDGE & FILL ��0 41252
GRAL PERMIT Previous permit#
l Modification OCompiete Reissue ❑Partial Reissue Date previous permit issued de
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 7/-/, 2 Z*7-)
Ig Rules attached.
Applicant Name AAjr� ��ta Project Location: County ) Jrk
Address )Al2
CityState �lC`ZIP �'l
Phone # ( } I H 0 Of Fax # (_)
Authorized Agent A
Affected D CW DEW Y PTA DES ❑ PTS
AEC(s): ED OEA 0 HHF ED IH ❑ UBA ❑ N/A
❑ PWS: OFC:
ORW: yes / % rr4A yes 10 %.rm. nao. yes i no
Street.Address/ State Road/ Lot #(s) L t s
Subdivision
CityQ Ask,n_s Al n Zip Yek,.`!
Phone # ( ) River Basin /� - >�,�� ro
Adj. Wtr. Body axcI (fit' /man /unkn)
Closest Mai. Wtr. Bodv r PxkI (, I '°
Type of Project/ Activity ?�A
b, mp r),1�1
Pier (dock) length
Platfo
Finge
Groin
Bulkh
Basin
Boat
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Shor
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length
number
ead/ Riprap length
avg distance offshore + L
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max distance offshore
channel .R
cubic yards
ramp
ouse/ Boatlif......
rh Bulldozing i
1771
eline Lengthyes no
fJ
bags: not sure yes
orium:
-
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—
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n/a yes
os: 19 no-
er A.•r-�rhorl. �S I i 1 I t ! t � � ' ' ' IT_ _�.�w _. .._..�_..�._. _..
A building permit may be required by: sr-S1,4
Notes/ Special Conditions
Agent or Applicaiiit Printed Name
1-114
Signature Please read compliance statement on back of permit
fir
Application Fee(s) Check#
V11 See note on back regarding River Basin rules.
PdFmitOfficer's Signature
Issuing Date Expiration Date
Local Planningjurisdiction C✓ Rover File Name
A building permit may be required by: sr-S1,4
Notes/ Special Conditions
Agent or Applicaiiit Printed Name
1-114
Signature Please read compliance statement on back of permit
fir
Application Fee(s) Check#
V11 See note on back regarding River Basin rules.
PdFmitOfficer's Signature
Issuing Date Expiration Date
Local Planningjurisdiction C✓ Rover File Name