45121_TOWN OF ATLANTIC BEACH_20060523 (3)

AMA / )dbREDGE & FILL lr ? 4 512 E
GENtRAL PERMIT Previous permit #
NNew ❑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
(_ QC P I�n ules attached.
Applicant Named-� hl�o4�,�j�sYj��-�f7 P oject Location: County
Addres Street Address/ State Road/ Lot #(s)
City State ZIPW I I - & )d
Phone # () -f axe# (_/ ) j Subdiv'sion
Authorized Agent /�(%j �1 ,](6 1/��E l City ZIP a
Affected ElCW )tdW PTA ❑ ES ❑ PTS Phone # ( River in
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body nat unkn
❑ PWS: ❑F
ORW: yes no PNA yes Crit. Hab. yes / no Closest Maj. Wtr. y
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore_
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing --'-- -
Other Ls/
Shoreline LengthA•—�
SAV. not sure yes no
Sandbags: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes ---- -
A building permit may be required by:
Notes/ Special Conditions
•
(Scale: �� )
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❑ See note on back regarding River Basin rules.
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Agent or Applicant rin d Name
Signature ** a read compliance statement on back of permit **
Permit
Issuing Date 1 ( Expirition Date
I n I P nnninv It ricr♦irtion Rover File Name