Cleveland, Don_001

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Phone# ( -- )
Adi. Wtr. BodY_-*
Closest Mai. Wtr. BodY
Basin
\ffected
\EC(s):
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(Scale:
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)RW:yes PNA yesno
Type of ProiecU ActivitY
Pier (dock) length --- ---*-
Floating Platform(s) - --, ---*-:
Finger Pier(s)*-
Groin length
-number ---- * - * *- -- :
Bulkhead/ RrPraP length-. -
avg distance o{fshore._- --
max distance offshore- - . - --
cubic Yards.,
Boat ramp
Boathouse/ Boatlift
-=_-- - '
Beach Bulldozing
Other--_.*
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Shoreline Length . -. --.-----.--.---'
SAV: not sure Yes no .
Moratorium: ola Yes
Photos: Yes
Waiver Attached: Yes
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ SPcclal Gondltlons
no
no
no (/,>\
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RECEIVED
i-l S.. note on back regarding River Basin rules'€ho.*
Application Fee(s)#
PermitOfflcer's
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Signature ** Please read compliance statementon **
VIAIilDBEDGEEHLL ( (or<*r'1
i -iModification L-lComPlete Reissue ilPartial Reissue
l'*lr i + 1;.,:l
Previous Permit #
Date Previous
A ' €i D
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:nd the Coastal
rpplicant
by the State of North Carolina, Department of Environmental
in ol
Quality
pursuant to l5A
Proiect Location: CountY
Street State
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