84656C - Addison, Ric

XCAMA ❑ DREDGE & FILL N9 84656 A c
((OEENER!n�L F�E(ice1�01O�5r Previous permit
` lS tf�,��L tr"LS=: Cf1�YB Il Date previous permit issued
IV14evv ❑Modification ❑ Complete Reissue ❑Partial Reissue
As authorized by the State of Na/Li4 CarolllnA Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC 07 1 • );)-OQ ❑Rules attached. �5 General Permit Rules available at the following link: www.deq.ncgov/CAMArulw
Address
City "
Phone #
Affected ❑CW s„ REW ),PTA ❑ES ❑PTS
AEC(s): ❑OEA ❑IRA ❑uW 1:15PIMA ❑PWS
ORW: yes/ oA PNA: yes/19
Type of Project/ Activity
Authorized Agent IF iC
Project Location (Count),):
StreeLAddress/State Road/Lot#(s)
Subdivision d �4 44 je
City ZIP
Adj. Wtr. Body v (nat/�iardnk)
Closest Maj. Wtr.
t t
Shoreline Length
Access Length
Pier (dock) length
Fixed Platforms)
Floating Platforms
Finger plefs)
Total Platform area _
Groin length/#
Bulkhead/ Riprap lens
Avg distance offshore
Breakwater/Sill _
Max distance/ length
Basin, channel_
Cubic yards
Boatramn
Beach
Other
SAV observed: yes
Moratorium: n/a yes
Site Photos: s
Riparian Waiver Attached: ye /
A building permlVzoning permit may
Permit Conditions __./ /
m
required by: r . 1 C O • 1
if
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back

AMA ❑ DREDGE & FILL JQ�/
GENERAL PERMIT
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
N9 84656 A OD
Previous permit
Date previous permit issued
As authorized by the State
of NoJrt.I�f-Carolin Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC D7 1 �O ❑Rules attached. General Permit Rules available at the following link: wwwdeq.nc.Yov/CAMArules
Street Address/State Road/Lot #(s) "�
Email Subdivision
City ZIP
Affected ❑ CW NEW ❑ ES ❑ PTS Adj. Wtr. Body ~ V (nat/ an nk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. BodyNVIji!
ORW: yesA PNA: yes/0
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s) .goif—
Floating Platform(s
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length C�)
Avg distance offshore
Max distance/ length I
Basin, channel
Cubic yards
Boat ramp f _
Boatho
B ng l✓
Beach
C/ I`�/ \✓
Other
r
SAV observed: yes
Moratorium: n/a yes
Site Photos: s
Riparian Waiver Attached: ye n r
A building permit/zoning perms may be required by: t ��
1 AM AWARE OF STATUTES. CRCRULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND
or Applicant PRINTAD Name Permit
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
Initial)
SignaturV lease read.compliancestatement on back of permi['��
.n/-t/..1y' �� =d _
Applic on Feels) Check #/Money Order
Date