Utley, Marvin

®❑LAMA / ❑DREDGE &FILL NO. 74433
A B �.0 D
.G,{_,ENERAL PERMIT Previous permit#
t�,iNew ❑Modification ❑Complete Reissue It 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 I SA NCAC
>1/'% r i Y'1 Ac Rules attached..;
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Phone #
Authorized Agent
t CW
Affected
AEC(s):
LJ OEA
❑ PWS
ORW:
yes / no
)(EW )l(PTA El ES ❑PTS
❑HHF ❑I1.11 OUSA ❑N/A
PNA yes / !no
Type of Project/ Activity
Pier (dock)length V
Fixed Platform(s)
Floating Platform(s) ql�
Groin length
number
Bulkhead/ ftiprap length
avg distance offshore
max distance offshore ._....
Basin, channel ^--
cubic yards `r
Boat ramp
Boathouse/ oadif G l
Beach Bulldozing
Other + ' .•e )-
i
Shoreline Length / -
SAV: not sure yes 'no
Moratorium: n/a yes q
Photos: yes o I
Waiver Attached: & no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
i
Lilt .1 1"J a-, K
Agent or Apolicaril ted qame
�f
Signature "Please read compliance statement on back of permit **..
...� .:
Application Fee(s) Check #
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City -
FA17
Phone # (_: _) _ River Basin
Adj. Wtr. Body
Closest Maj. Wtr. Body
(Scale:
(pat /man /unkn
❑ See note on back regarding River Basin rules.
Permit Officer's Printed Name
Signature
Issuing Date Expiration Date

RECEIVED
APR 17 Z019
DCM-MHD CITY
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RECEIVED
DCM-MHD CITY

CERTIFIED MAIL' R RETURN �ECLIeT REQV�LD �E --
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONrWAIVLR FORY,
wil"Po V, t4m n, 03ys of f(-cewf W M,.s iotiCc -wnacf •nforrvatior, mr (Y)V.
ij 1,bplalhoq 1-E88-417CQAS'
Nu response is co,is;dered IN same as no ohlect 1,011,100 by corptied Ma"
,UAIVER SECTION
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(Riparian Pro Perry 0%."Ier Info Olatroru
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AQJACE.NIRIPARIAN PROPERTY STATEMENT0ff� -E—
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of Property Ownerl
^-ratel al iNT> I tz
Address. Lot. 81cack, Road, et.c.)
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(Waterbcxiy) (City;Town and.for County)
DESCRIPTION AND:IOR DRAWING OF PROPOSED DEVELOPMENT
tindividual proposing development must fill in description below or attach a site drawing,
WAIVER SECTION
-'I ! 111e. rl"I".1i,o �)Ilwgs t,,aj gal nu.
v'i'Te i must mitiae ac:VWe L'P'lk
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a . o not OV
V,' Sh �.'o Me. I
(Adj'aceo( Property Owner
,711 -,?Pat - 5-� to, ��At
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RECEIVED
APR 17 2019
DCM-MHD CITY