Keeler, Mike 78871C

CAMA / DREDGE &FILL V N9 78871 A B C� D
GENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality ' '
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC �� co
, r `l'-.tJ
/�� j/ - ( XRules attached.
Applicant Na/mye' ((y y1 i g- C k;a4 � Project Location: County
Address "1 �f 7� So ( X�F 1 lie, Street Address/ State Road/ Lot #(s)
Phone # ( -2i r E-Mail
Authorized Agent
Affected ❑ CW � 2W� 11!9 ❑ PTS
A
Affecte ❑ OEA ❑ HHF ❑ IH 1-1USA❑ N/A
❑ PWS:
ORW: yes no PNA yes /(9
Type of Project/ Activity
Pier (dock) length .�
Fixed Platform(s) -�
Floating Platform(s) f
Finger pier(s) /
Groin length /
tuber
ulkhe / Riprap length
avg distance offshore
max distance offshore
Basin, channel
/
cubic
Boat ramp
Boathouse/
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes n
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes n
A building permit may be required by: _
( Note Local Planning Jurisdiction) n
N itep/ Special Conditions
,!
•s' Please read compliance statementon back
ear
Fee(s) Check#
Subdivision A
City ZIP
Phone # () River Basinu�l/ lak
Adj. Wtr. Body 1 CQ nat unkn
Closest Mal. W* Body r 1 f4l VAS
t
(Scale: , `r
ltA
❑ See note on back regarding River Basin rules.