Abrams, Ricky

®[3CAMA-/ ❑ DREDGE & FILL No. 75225 A B C,.- D
GENERAL PERMIT Previous permit # p"
[AeW ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality �/ f _ 1 �,
and the Coastal Resou/Cis Commission in a area of environmental concern pursuant to 15A NCAC 111 [�"
�. y^r r /41 j -, ❑ R�les attached.
Applicant Name I r i / ` I ` ' Project Location: County C- r-y G'-
City C LA
Phone #,((G
Authorized Agent
Affected EJCW
AEC(s): L10EA
❑ PWs
l:
StateZIP
E-Mail
-ljEw -ffi'PTA Li Es ❑P-rs
❑HHF ❑IH ❑UBA El N/A
no PNA yes/
Type of Project/ Activity
Pier (dock) length_
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap le
avg distance o
max distance i
Basin, channel
cubic
Boat ramp
Beach Bulldozing
Other
Shoreline Length ,
SAV: not sure yes no'
Moratorium: n/a yes A r
Photos: yes in '
Waiver Attached: yes no
A building permit may be required by:
( Note Local Planning jurisdiction) r
Notes/ Special Conditions-� /r. -- ✓ ' 't'�`"
f! C le i
Agentoorr Applicant Printe/d/'JNN d
Signatur,.i � "rP{ease read compliance statement on back of permit
\pplication Fee(s) Check #
Street Address/
(/StateRoad/ Lot #(s)
Subdivisippn
City �/� {� l� �' �✓ ZIP
Phone # ( ) ver Basin l I A, L
Adj. Wtr. Body, 4 ) �d . c nat /man /unkn)
Closest Maj. Wtr. Body
(Scale: /i % (/
❑ See note on back regarding River Basin rules.

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