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' CAMA/ ❑DREDGE &PILL' /� /-� No 73U21 � ' :_'
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GENERAL: PERMIT :Previous Permit# �,
/r,r— New ❑Modification ❑'Complete'Reissue ❑Partial Reissue = n n Date previous permit issued:G%�f ' -
1. As authorized by the State of North Carolina,Department of.Environmental Quality /i( )
and the Coastal Resources Cornmissio in an area,of environmental concern pursuant to 15A NCAC . : ,//'/P •. •
(� . ,ules ttaacched: ,
,. .
Applicant Name teziiy . , Q�''' - '`„ . Project Location::County r'.F('6' • ' ,
Address � �( : ./ 1C� Street Address/.State Road/Lot#(s) , -
City/att., -2, ,d6/OC/Z-- iState/j/Z-ZIP P- /rrr)f C('G1 AL/AIJL-- --�721P .
Phone#;�/�� sl( E- ail / ' Subdivision' n ' . ,/`> . -
Authorized Agent �c%(�( �GT�' d`'� • CityIf� ,-- .
ZIP i� �/ •
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O CW E- /(PTA ''❑ES ❑PTS Phone# ( ) ` `1 River Basin `mil Gf7ln '
Affected. . 0 0EA 0 HHF El IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body( +(Oil (/1. 7)NONIi4a'P4K (nat /man /unkn) .
❑ PWS: ,9 / r
ORW: yes / no PNA yes no
Closest Maj.Wtr. Body // fi1 r7/17 </; -- •
Type of Project/Activity i�' f. /C T9 �7 .c ��' x 4-,/,-/irk 4��,�7 ��x/ r 4,0, A
/)i gI/(Y� 4W rat--fit/OFf�r't, G, 4/Xm��,'/( /�/,,P,C/ (7`i t7,-)) G' C/ �' '
/ ,� ,/� (Scale: �i��' )
• Pier(dock)length nC',Vo?6 '/, A i �'y I°_,i,r�) J;� ��( , L. .(%�1 ._/ �/ y
Fixed Platform(s)�1 /4�k', —r/' ( /,` I ' •,+
Floating Platforms) cc/k 30 ,
Finger pier(s) �' '
. Groin length I '
number ` -
Bulkhead/Riprap length "— ``
avg distance offshore '°"' I I / III1
max distance offshore _ F -I./6' ,ie _re 1 / , ;Ljrdr',
Basin,channel � � t I E
l
9 7.� /
cubic yards �,.�
- Boat ramp / `
Boathouse/Boatlift 141`. . .4. Ili
111114
Beach Bulldozing NI
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i3/►4irii I ilr■■li■■■■■■■■■11■■■■■ I ■rom ■■■■■■■
Shoreline Lengtll/9 ��
Moratorium
n/a yes g11111111111 1111111Frillill
5111111NIi ■■■ ? ,f�1 ,r It
y' Photos: yes ■ rIEYNIMEri '� ■■■11U w • ■1�//iVI� ■■ '•
or
Waiver Attached: yes
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A building permit may be required by: kG'l/1(/%4 (// See note on back regarding River Basin rules. -
(Note Local Planning Jurisdiction) r ��� r Notes/Special Conditions �G°� /�JJ!(//G('G// /�/�c,„�i /��/// ri3?`' _ /� , , •
. l h dir G/ G.�'�/,� i 1, ill , .,Cr/./11 :f2.. i ?r r`^ 0. "/)/;,) / �ic.t /71 (, Cc1/---:
/�rif � 4r/ 76e71" \
1171► V 0 /1n6 011 S-Th4-Z--- :;e2-1/7 - ,2 , . !
Agent or Applicant Printed Name Permi Officer's P ird ame
Signatur " �(e a ,e d'compliancestatementonbackofpermit- `Signature
' . 0 �� /�, rr;4)079 /' �1-
, pJlication Fee(s) '\ . Check# Issuing Date v Expiration Date . -
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NC Division of Coastal Mgt. Habitat 'Impact Computer Sheet
Applicant: I Jc
Date: CAI/
General Permit#:
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Describe below the HABITAT disturbances for•the application. All values should match the name,and units of measurement •
found in your Habitat code sheet.
TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet
(Applied for. (Anticipated final (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance.- Disturbance disturbance.
Habitat Name Choose One . includes any Excludes any total includes Excludes any
anticipated restoration any anticipated restoration and/or
restoration or and/or temp• restoration or temp impact
temp impacts impact amount) temp impacts) amount)
Q4r Dredge El Fill❑ Both ❑ Other
9eA l Dredge❑ Fill❑ Both ❑. OtherA
fr.,a)// Dredge❑ Fill❑ Both ❑ Other 02t ()
t 7 eb 76redge❑ Fill❑ Both ❑ Other'
T4
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑- Other ❑
Dredge❑ Fill❑ Both ❑ .Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
. i
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑ •
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