Humphry, Walter 77023C signed copy

8/28/2020 Image (129).jpg
4EFE
/ ❑ QREDGE & FILL 1�fi 9 7702 3 A B OD
RAL PERMIT Previous permit #
Modification 7Complete Reissue Partial Reissue Date prev'ous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Co fission in ea of environm�nW concern pursuant to 15A NCAC
les attach
Applicant Na e �1 ' Project Location: County
Addr Street Address/ State Road/ Lot #(s)
City State ZEP�'
r
Phone # ail Subdivision '—
Authorized Agent City- ZIP
Affected N4W A ❑ES ❑PTS Phone # ver Basin
❑ OEA ElHHF IH ElUBA El N/A
l
AEC s : Ad'. Wtr. B a an unkn {) Body
PWS:
ORW: no PNA yes / o Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: }
Pier (dock) length
i } 1
Fixed P3atlorm(s) :-)7
Floating Platform( _
Finger pier(s)
Groin length---- I I i }
number -- --
Bulkhin
ap length 1' i
I
nce offshore _-nce offsho aBasin,ds
Boat TBoathni
atli Beaching— II-- - - —�-
i
Other
I : h'1 If► I I
Shoreline Length
Spy: not sure yes I no ri
Moratorium: n/a yes' noPhotos: yes no -
WaiverAttached: yes n- ICI
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
or
SiSn atuPleAeread M
to back of rmit
to
Application Fee(s) Check#
i l
:
;-
--r—.-
-
❑ See note on back regarding River Basin rules.
Isssuu r g a e Exnira ion Date
https://mail.google.com/mail/u/0/?tab-wm&ogbi inbox?projector--1 j11