Ellis, Lisa

F, CAMA / ❑ DREDGE & FILL No. 73949 A B C D
GENERAL PERMIT Previous permit# J - /I
❑New ❑Modification [_]Complete Reissue ❑Partial Reissue Date previous permit issued / ' //.
As authorized by the State of North Carolina, Department of Environmental Quality 7N l c G
and the Coastal Resources Commission in an area of a vironmental concern pursuant to 15A NCAC
El Rules attached.
Applicant Name ! J� i I Project Location: County
Address ? ' I Street Address/ State Road/ Lot #(s)
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City p State ZIP
Phone # �/) = E-Mail , Subdivision
Authorized Agent City ZIPI. • f
❑CW ❑EW El PTA ❑ES ❑PTS Phone# O River Basin 1..�
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): El Pws: Adj. Wtr. Body i (nat,iman /unkn)
Closest Maj. Wtr. Body f"
ORW yes i no FNA yes, i no
M MEMEMEMEMEMEMEM ME MEMO
length
t ramp
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to: yes o
0
MEMMEWMM
ME
MEMO
am
ME
am
HEME
so
0
MEIN
OEM
MENEM
MEN
0
IN
0
MENEM
MIMENIMMEMI
SEEM
0
MEN
0
EON
MOEN
MEN
0
MEN
Flioll
NINE
III
SEEM
0
a
0
0
a
MEN
MEMEMEMME
ME
EON
ME
a
No
OEM
.
--
....................................
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length
iii■iii�iiii■iiiiuioi■■■wii��i�*iiavg
distance offshore
max distance offshore
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Agent or Applicant Printed Name
Signaryro •* Please read compliance statement on back of permit"
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Application Fee(s) Check#
Permit Offce. s P inFed Name
Signature i
Issuing Date 13�piration Date

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AMA/ J DREDGE &FILNo. 731 I1 �'�A B C:/D
NERAL PERMIT Previous permit#
w ]Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality —'/] %/ 1160
i.1
and the Coastal Resources Commission in an ar of environmental concern pursuant to 15A NCAC /7
El les attached.
Applicant Name ��� A Ar __ Project Location: County
Address C c_ V� Street Address/ uStabttenyRoad// Lot #(ss) /
Ciry L State�czlp —/ V ` V V
Phone # — E Mail �__ Subdivisi
Authorized Agent I Ate' /Y CityC _ zip 2
Affected �CW ❑PTA 7es ❑PTs Phone# (_) River Basin
G OEA HHF CIH ❑UBA EJ WA
AEC(s): Adj. Wtr. Body � Via%)
❑ PWS:
ORW: yes / no PNA yes / o Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length __
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
- j
Bulkhead/ rap length
distance offshore \
max distance offshore
Basin, channel
cubic yards
Boat ramp •�
Boathouse/ Boadift_ I f
I i
Beach Bulldozing
Other � � I i 2 I(c.{L.ri
Shoreline Length
SAV: not sure yes
V
Moratorium: Is yes
Photos: yes
-
Walver Attached: yes'.._
-�
A building permit may be required by:
( Note Local Planning jurisdiction)
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6c.,
Notes/ Special Conditions
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(Scale:
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❑ See note on back regarding River Basin rules.
Signatue xa Please read comphance statement on back of permit •* Si atu
Appliwdon Fee(s) Check# Issuin Date Expi t