72511A_Lysle K. Ailstock_20190103

IXCAMA / '❑ DREDGE & FILL
GENERAL PERMIT
XNew Modification ❑Complete Reissue El Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC,
Applicant Name S) c K. b i` SA oc -
Address 3og N . o0e, wcu r
City S ,,t h. i State 1`J c ZIP )1C,ut`+
Phone # (-45-4) 4 ».- 5 -4-4-4 E-Mail
Authorized Agent
Affected ❑ Cw
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / 6)
[,EW %PTA ❑ ES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
PNA yes / no'~
No. 72511
Previous permit #
Date previous permit issued
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FY Rules attached.
Project Location: County D o e
Street Address/ State Road/ Lot #(s) 3oq N, It I
Lug d.� .� } " a
Subdivision ---
City ZIPa-4r,`i5
Phone # ( )n River Basin Ir
Adj. Wtr. Body ` u r r �.� k �.� �^ a®t /man /unkn)
Closest Maj. Wtr. Body Cur r . I., c IC
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Agent or Appli t Printed N
Signature * Please read compliance statement on back of permit
Application Fee(s) Check #
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Permit Off ame
ture
I / 3bw 19 9 44o)0,01g
Issuing Date Expiration Date

Previous permi(*�-
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 7H M.f�g
)Z Rules attached.
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Applicant Name 1- r!� K, A I V�100< Project Location: County_DY21 — I
Address DOI
City-- �AAk Tr--�O State �4 ZIP
Phone # O j Fax #
Authorized Agent M i Ltl<71- - V I
Affected [] CW ;aSW ;�A �DES Z OTS
AEC(s): [I OEA 0 HHF El 1H [I USA El N/A
[I PYVS: [I FC:
ORW: yes A Cno!�> PNA yes / no' Crit. Hab. yes no
,-�ZCAIVIA / -� DREDGE & FILL
ERAL PERMIT
GNI --New --Modification '- Complete Reissue �----Partial Reissue
Street Address/ State Road/ Lot #(s) LO-1 C)�-
Subdivision
City ZIP
Phone# O River Rn-dn
Adj. Wtr. Body CJR-R—jqJ(x (rniat man Junkn
Closest Maj. Wtr. Body
Type of Project/ Activity MAT,
(Scale: %,�CK,7
Pier (clock-)�
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WOMEN
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Riprap length
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distance offshore
distance
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offshore
mnel
SE
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ic yards
NJ
p
P-
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"HOMES
jildozing
lama
ON
Mm
NEI
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Length
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notsure yes no
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not sure yes no
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no
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yes no
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Bulkhead
avg
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Basin, ch.
cub
Boat rarr
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Beach BL
Other
Shoreline
SAM
Sandbag!
Morator
Photos:
Waiver -,trarJi,-A ye-s--no
A building permit may be required by: ­n, \16-1 El See note on back regarding River Basin rules.
Notes/ Special Conditions -4 eA 0 1 O A A P v 1'r V- CN C)-O i 3- i-T t V %A+'
iJo
Agent or Appli �t PrintedName Permit Officer's Signature 4
UAL,,
Signature Please read c: statement on back o' permit ompliance s of permit" 1ssuing Date 5xpiration Date
Local PlanningJuriscliction
Appli6�onFie'e(s) Check # Rover File Name