Elizabeth Coffey 71761D

eIWAMA/ DREDGE & FILL
No 71761 A B C 0
GENERAL PERMIT Previous permit#
>G kNew ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality ��/r�• 25� l e ,ru
and the Coastal Resources CommissionI - in an area of environmental concern pursuant to I SA NCAC RulesEl attached. )
Applicant Name El, Zak 1/, S.. CI Project Location: County ,L 444,y,ovtG(
Street Address/State Road/Lot#(s)
Address J 32 3 Li V'e Oak. ?k W�/ 7
City � I
. 'Yt,Y1s 4 r p State N( ZIP Z {03 Z U a j Actou )
Phone# ( LO )26g—9 S 35 E-mail Subdivision --
Authorized Agent vtntvtq /Voy4(.. City IN/l rY►i,( 4- y' ZIP 25411
IvS ( ) — cp.-I?,
Affected ❑CW �EW PTA �S ,�(PTS Phone# �t�1 I CRiver Basin
AEC(s): ❑0� ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body I v`i c1 �e Sow (yi an /unkn)
❑ PWS: r� C1p h
ne
ORW: / no PNA yes no Closest Maj.Wtr. Body Dl�v► 5
Type of Project/Activity kP f 14e dAim.a�[ l(os +A-J dock&f r�fr{ 1A LLutc
o (Scale.•
1�� : kit) )
Pier(dock)length Z.--
` I 1 ,
Fixed Platform(s) j
Floating Platform(s)8 X zo Cr20) 1 n
1 , _ �' V•
kr' -1\IVIDA. k
Finger piers) _ (�Q�'.t�-- — .._..
Groin length
number
i Bulkhea /Riprap length 40
avg distance offshore 0' kS
Rr
max distance offshore Q — �� p \� •
Basin,channel .4,•tib !1
Icubic yards
Boat ramp 1, I ■
Boathouse/Boatlift *
Beach Bulldozing / f,...4.r I G*
Other NG: 1�B0O 4 '�/' la
ki\
Shoreline Length /5'0% irI Th •' y >,
SAV: not sure yes •
)111" t'
Moratorium: n/a yes c�
Photos: yes \�j�� ' iti j).... ? '� i
Waiver Attached: yes411; y eA.-, Dt J�� �
04,
A building permit may be required by: / iCAni 4/uf0Vex- C.0. I I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) c d / �j / I ) J-
Notes/Special Conditions KV le 07g�. 2 00 6� cal f7T dIAU I ) S'T"Q.. f Q.` J
l0 `41 (t ,ulGtIor t a t y. A)0 " Awry. adit' a.t1'Ct oeze,1.
Si-0Cl
Agent or Applicant Printed Name Pe ' Officer's Prin ame
Signature **Please read compliance statement on back of permit** ignature
ti4 /tJ- __ IO 31I1g q/uri1
Application Fee(s)
Check# Issuing�Date Expiration Date
1

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
64 Name of Property Owner Requesting Permit: e 11 Zej
Mailing Address: 13 2-3 4V-Q- C -� --`-C ii�oM—
(; / ixt P . 7z Lr) 3
Phone Number: g I 0 I Z C2 Lt _ ?6 3 b
Email Address: (A:5 &K))C° met e , e( 4A—
I certify that I have authorized ,4 ,`,-r, / ( ,
Agent/contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: '? plane ki tc.✓_eV
'S`!o SU,.:)- c ( °L`.t s I-- . _ b u t Lie c_4,
at my property located at z� ��c'u�/& L i1'"`� -��, t�� "ry t i �-,22'�
in (tee.,;} /'a,;i co-eCounty.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
eit-3sak-CakS
Signature
f� 1( tic) ee-fejPrint or Type Name
O7A-\MA Title
0--I tZ.Li Dao I 2_0.
This certification is valid through I_ I

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