Britt, Cedric

y
7CAMA / ❑ DREDGE & FILL % No. 74419
GENERAL PERMIT Previous permit#
r'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
I ❑O Rules attached.
Applicant Name ) t i r 1 Project Location: County
Il
Address V�.i i -? _ c' 1 K (- =` I �/ t\ LtV Street Address/ State Road/ Lot #(s)
City State /'i ZIP
7;
Phone # 4-Mail _
Authorized Agent
Affected El OW ' n EW .--Eb PTA El ES ❑ PTS
): ❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(
❑ PWS:
ORW: yes / no PNA yes / -no
Type of Project/ Activity
Pier (dock) length0�l
Fixed Platform(s)
Floating Platform(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore
Basin, channel
cubic
Boat
Beach Bulldozing
Other/ I `-,. ,5.�. ..
Shoreline Length
SAM not sure yes no -
Moratorium: n/a yes no _
Photos: yes no
Waiver Attached: yes no
A building permit may be required by: U..1.� 11. � E'
( Note Local Planningjurisdiction) f
Notes/ Special Conditions�
(c''tiC
Agent or.Applicant Printed Name r I
Signature 'r* Please read compliance statement on back of permit" r
Application Feels) Check #
City
ZIP
Phone # O River Basin
Adj. Wtr. Body o' (nat /man /unkn)
..
Closest Maj. Wtr. Body
. , 1 ._._.r - , r /'F it-Il
(Scale: )
'0 See note on back regarding River Basin rules.
Permit Officer's Printed Name
Signat e
Issu)g Date' Expiration Date