Lesan, Doug 78872C

A CAMA / DREDGE & FILL ^' Np 78872 <Z) D
GENERAL PERMIT Previous permit#
❑New ❑Modification 'kilbomplete Reissue ❑Partial Reissue Date previous permit issued O
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 15A NCAC ?
Ru s attached.
Applicant Name bn � - Project Location: County 0 f_L Ou
Address_ XC2 L-aA y{Xa Ke.-V U 1� l VP Street Address/ State Road/ Lot #(s)yLl T
city
Phone #
Authorized Agent /VID(>i'lAe k
Affected ❑ CW kEW- {EFTA -" Cl PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ WA
❑ P S:
ORW: yes /l'y PNA ye / no
Type of Project/ Activity
Pier (dock) length f0 ^
yx
Fixed Platform(s)
f
Floating Platform(s)
Finger pier(s) 31s 3
. --
TT�
Groin length
-�-
number
Bulkhead/ Nprap length
avg distance offshore_
max distance offshore
�
1
I
!
J
L
I
f
Basin, channel
�
cubic yardsT
Boat ramp
Beach ]dozing -
Other?Je 1 ! 1
Subdivision
City ZIP o
Phone# ()_I_��_ RverBasin
Adj. Wtr. Body_,
Closest Maj. Wtr.
Shoreline Length i(/
SAV: not sure yes o - -
Moratorium: n/a yes
Photos: �yT�es��
Waiver Attached: [J -n --_—�-y ,�-r^ I
A building permit may be required by: V `OLCK Dn.V
( Note Local Planning jurisdiction)) E `/
Notes/ Special Conditions
or Appl c nt Printed Name
Sign cure •* Please read compliance statement on backofpermit**
Application Fee(s) Check 4
Permit
(Scale:
❑ See note on back regarding River Basin rules.