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BEN ERAL PERMIT Previous permit#
1New _'Modification 'Complete Reissue ❑Partial Reissue Date previous permit issued
-ized by the State of North Carolina,Department of Environment and Natural Resources �� /
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 27
❑Rules attached.
t Name C41w, T4 A)t..&'( Project Location: County a2e...(/St/r C._
/ ,� / 5r4� C9c &}y Street Address/State Road/Lot#(s)
>L Cc/(o 44-e State A ZIP Z '97 3 5 '-GOT4.4 ti✓) .5-7(
( ) 75 l ax#( ) Subdivision
ed Agent .�/ // City 'TQGv✓1 /$(a ZIP Zgy
U CW '4 ETA ES ❑PTS Phone# (V ), y GZZt River Basin t(J,n,
❑OEA HHF IH =USA O N/A Adj.Wtr. Body C /! 3 .n (flat(
❑PWS: Cl FC: - � �n
yes / PNA yes / Crit.Hab. yes / no Closest Maj.Wtr. Body C.C. — �Z
no
Project/Activity gp(AC(uC� £X(S r , Dori w/ Avbc) Faocre4-.•y D c( X 21
C) ,AJ ) l X /2. I4NG Oe-C' 0 (Scale: /N=
:k)length g 2,0
(s) ,,,Cl-- 4 L ' .., >
er(s)
igth I��tkd 'L
nber � ��j Pt
1/Riprap length
,distance offshore
x distance offshore II r0 r4 S� l
annel r
l rt Dares f
iic yards I /5
M
sp /S mL-
se/Boatlift
6,ret
IIIilldozing i
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not sure yesip
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ive?K •2�.. �L44i) 57
urn: n/a no ,�7 -RAL f�
- no LokiV� i I r /u.�n
ttached: yes 0 .{ / _: ,. SS��
ig pg mil mA be reouire0 t 0 0 0( OQi.r1 46 l/U5 DI'/- • See note on back regarding River Basin ru

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Three West Third Street ,
Ocean Isle Beach,NC 28469
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n 15 05 09: 51a Town Of Ocean Ile 910 579 2940 p.
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DAR1.114dTON8C /9532 g A L. USE
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trru :CERTIFIED MAIL, RECEIPT
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Cl 0470
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CO
ru . 06/02/2005
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N 'Sweet,Apt.Th.;
or PO Box No.
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PS Form 3800.June 2002 See RevOselor_InStructiona

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