Valario 72217 FLORENCE

MI 1-0f I I I t 1 P }t 0(2-12-icA.NE- V ► 116-JAY f i
0 JCAMA/ ❑DREDGE & FILL 0
l�- 72217 A B C ' D
GENERAL PERMIT Previous permit#
)C J New _Modification _:Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commiss'on i an area of environmental concern pursuant to I 5A NCAC (V5) fl 2.. sOC
❑Rules ched.
Applicant Nameb f f 4 0116 Project Location: County T r _
1.
Address p,c) 1 "ay,_. -2--- 6 I( Z Street Address/State Road/Lot#(s)
City 1 (.! ► State /vC ZIP7%7 y3 1 (LfC.--ot t, 0 (,(tet t 64.._ e(d .
Phone # j6) 5- oC) E-Mail Subd' ' ion 4
Authorized Agent 1 City t�. - ZIP �6
❑CW ❑EW ❑PTA 4 ❑PTS Phone# ( River Basi / ryI �ff
Affected: ❑OEA ❑HHF ❑IH ❑ BA ID N/A y4Z4k i )Adj.Wtr. Bod man /unkn
❑PWS:
Closest Maj.Wtr. Body �5
ORW: yes / noT) PNA yes no /
Type of Project/Activity (11-C/- )15. M U Q /' J1 4 ,
(Scale: -4...-2::_ )
Pier(dock)length
I
Fixed Platform(s) i I j
Floating Platform(s) i
Finger pier(s)
Groin length 14-G- C fes-iI� j
r � / (J ( f` V
ulkhead/�ipr)ap length ft.) /
I avg1ance offshore / f
/
/ ~_ t.
max distance offshore i
Basin,channel ��
cubic . ds I/
Boat ramp
Boathouse/Boat'ftt •;�1� ���� 1
' ' .-IN>l'.--... ."'"/""' 1 N. N.Beach Bulldozing
Other I p
4 - 0.4 - .'
Shoreline Length Vol 1 , (?
SAV: not sure yes -n i
Moratorium: n/a yes
Photos: yes (ao
Waiver Attached: yes 60 11 -
A building permit may be required by: \d ..i; . F. See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions •
/ n` , ' L
,
Agent or Applican.'tinted Name Pe, itit officer's Printed Name
V \V
Signature , Pie read compliance statement on back of permit Signat/r= I
i 1N 1.\\' / 1 • • ( e , 20 .
Application Fee(s) Check# Issuing Date Expiration Date

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