59895_CAREY, KENNETH_20120628

4CAMA / DDREDGE & FILL
GENERAL PERMIT Previous permit #
[ Nevv ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources `;� e
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC q}. iY 5)- i
ttached
Applicant Name (¢�" � / -CA,;��' T '
Address �� 6 � S�
City 9 "r 0� D Statee- ZIP -
Phone # ( Fax # (
Authorized Agent
Affected ❑ CW .PEW PTA OjES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / ncz PNA yes no Crit.Hab. yes
Type of Project/ Activity, �-�• ��_
Pier (dock) length
Plat
Fing
Grc
Bull,
Basi
Boai
Boai
Bea(
Oth,
Shor
SAV:
Sand
Mor.
Phot
Wai%
uesa
Project Location: County pf:= L, 1 ) , 7 g jm
Street Address/ State Road/ Lot #(s)
Subdivision
City .�.Fi59D ZIP-
Phone # River Basin
Adj. Wtr. Bod - ,2, 'iftiWjman /unkn)
Closest Maj. Wtr. Body- 42 ! :�:17iAll 5/'s
I
(Scale: 36 )
>_r pier(s)
I I
,
-
n length
number
head Riprap length
avg distance offshore—
maxdistance offshore j
i, channel
----—
cubic yards}
ram
house/ Boatlift
h Bulldozing
r�u,
Rt. RAI
1
4
Are Length
fn -1
not sure yes
gags: not sure yes
torium: n/a y
>s: no
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1
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Y
!!r Attached: ves f6
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A buildingpermit may be required b : ar j s r:l#t =- regarding River Basin rules.
p y q y ¢ ❑See note on back re g
Notes/ Special Conditions
o iN 1 rt f_ f�. k - ..� : ��` L 1;'% n:r Fitt/�, rL i
f
f �1
Agent orApPicanIt Printed Name
../ e
If
Signs ure ;` Pleas read compliance statement on
of permit
Application Fee(s) Check #
Issuing Date J Expiration Date
t o Iink
�.
Local Planning jurisdiction Rov File Nam
C(� 0's-/G P