Sutton, Mike Jr.

OCAMA / ❑ DREDGE & FILL No. 75747
�. GENERAL PERMIT Previous permit# A B C D
❑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 Commission in an area of environmental concern pursuant to 15A NCAC
El Rules attached.
Applicant Name `}'} % /) �� Project Location: County__
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Address C,,., (,�/ I \:�- Street Address/ State Road/ Lot #(s)
City ��r I ' �•`-n State!LC_ ZIP
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Phone # Subdivision
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Authorized Agent City - ''' i f r I - 1 y ZIP_ _ li
Affected LjCW .NEW _OPTA El ES ❑PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes /-no-) PNA (ye;il no
Type of Project/ Activity I
Pier
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Float
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Groi
Bulkl
Basir
Boat
Boat
Beat
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Sher
SAV
Moro
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A building permit maybe required by: ! /d.:� r--_' (�) I (i )[NSee note on back regarding River Basin rules.
( Note Local Planning jurisdiction). ^ /
Notes/ Special Conditions
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Agent dr Applicant Printed Name PermltOfficers Printed �am4'
Sign ture *' Please read compliance statement on back of permit's' Signature
ApplAppl uion Fee(s) Check# Issuing Date Expir tion Date