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CAMA / DREDGE & FILL Q�' �! NO, 72865
—• A C
GENERAL P R M I T Previous permit # o -D
Tew Modification omplete Reissue -Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality f�
and the Coastal Resources Commission in a area of environmental concern pursuant to 15A NCAC 0 7 r/ ./ (ZOO
/�/ ❑ es attached.
Applicant Name f' v� Project Location: County
Address G Street Address/ State Road/ Lo #(ss)
City Stat ZIP Q ( � % N j J�
Phone # (�) Y'� E-Mail
Authorized Agent /y / 0-
Affected ❑ CW ,,�1 EW �TA El ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes, no PNA yes no
Subdivision
City iV , ZIP ZJ C-160
Phone # ( j--- River B i� '
Adj. Wtr. Body t/dk ,7 nat an unkn
Closest Maj. Wtr. Body-_ 0�-
Type of Project/ Activity f �( Z/ a/ 164 -641
F /
Pier
Fixed
Float
Fing
Groi
Bulkl
Basir
Boat
Boat
Beac
Oth(
Shor
SAV
Mon
Phot
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A building permit may be required by: / v • / W1a
( Note Local Planning jurisdiction)
Notes/ Special Conditions
or ApplicarA Pfinted Name
U See note on 1
t
Permit ficer's Printed Name
*3*el *0 Please read compliance statement oi, back of permit" S nn�uref
Zo0yu� 1�610W7,Y9S - / - / q `7 -
Application Fee(s) Check # Issuing Date Expiration Date

r CAMA / DREDGE & FILL r�
Previous permit #
GENERAL PERMIT
Date previous permit issued
DfNew L--'Modification Complete Reissue !-,Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality Af
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC n Rules attached.
Applicant Name r f% __ -- --
Project Location: County_ --
t r `� y� _ Street Address/ State Road/ Lot #(s)
Address f
! a _
�_ ZIP �.��%'� ��� Al
City#�(>t State
, _ l
Phone # (.__)=` E-Mail' - ty'�+ Subdivision _ P
---
' -- ZI -
r r City f Authorized Agent
CW AEW PTA _ 0ES r-, PTS
Phone # ( )�� River Basin --_-__
Affected Cw HHF ❑ P ❑ UBA I N/A t%.-Yi r ,(fla lman /unkn)
AEC(s}: Adj. Wtr. Body---_� -` s . h _ r
PWS:
- Closest Maj. Wtr. Body.--
ORW: yes l; no PNA C V no
Type of Project/ Activity
Pier (dc
Fixed P'
Floating
Finger 1
Groin 11
rn
Bulkhe
a
n
Basin,
c
Boat r
Boath
Beach
Othei
Shore
SAV:
Mor,
Phot
Wai,.
A building permit may be required by:`�
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
Yr�
Age ntAr Applicant Print � N e
J
k Signature Please read com lance statement on back of permit **
Si tiatut-e
$
_-- -- Check #
Issuing Date
Application Fee(s)
i
(Scale:
See note on D"dac 1 %%a — �6 - -
Printed Name {
Expiration Uate