72575A_Panos Tryfiates_20190218

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-VCAMA / DREDGE & FILL
GENERAL PERMIT
XNew —Modification El Complete Reissue ❑Partial Reissue
No. 72575 C) B C D
Previous permit #
Date previous permit issued
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 15A NCAC .
KI Rules attached.
Applicant Name PG r,o S TnI Project Location: County v r r , � v L /C
Address y ),ty Rc Street Address/ State Road/ Lot #(s) 1) (' Shc)f e br
City 1=rc�fILVS6,,rg State VA ziPaauog
Phone # (aOW L4c11-9Sd 1 E-Mail
Authorized Agent
❑ CW
J1 EW EXPTA ❑ ES ❑ PTS
Affected
AEC(s): ° OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes /62
PNA yes / no
L
Subdivision V),)Oh J2•v-ct
City Sa(y+sb"fg zip Li
Phone # ( ) River Basin e, sr, U e f k
Adj. Wtr. Body A 6&.., o f jt na man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity V_t 0 Ia a 5+,> ti F (�. t ✓ T j� i ua c +� . r S
(Scale:
le (dock) lenoth 4 3Q `Y
Floati
Finge
Groir
BulkF
Basin
Boat
Boatl
Bead
Othe
Shorr
SAV:
Mora
Phoa
Waiv
v
A building permit may be required by: c k ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/Special Conditions i p,cr c1c,i�or.v-\ rv,c., R,Y 6.'L t�J 64 Ore-Orm clr+rvvrS,",.i
Agenlic t rimed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
PermitOfficer's Pr' ame
/r
i�
Sign ure
r �/�(714 91a,)Ia.u19
Issuing to Expiration Date

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