Moore, David 78839C

CAMA / ❑DREDGE &FILL �W N9 78839 A B © 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 15A NCAC L-W
Rules attached.
Applicant Name l Project Location: County cxaeo
Address Street Address/ State Road/ Lot #(s) ^'1
State ZIP� o
Phone # (,W)l,
Authorized Agent
Affected El CW
AEC(s): ❑OEA
❑ PWI
E-Mail
1' •' 'PTA ❑ ES ❑ PTS
❑HHF ❑IH ❑UBA El N/A
ORW: ypro PNA yes / 0
Type of Project/ Activity OV0/
Pier (dock)length
Fixed Platform(s)
Floating Platform(s)
Finger piers) X Q
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore i
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boadift
i
Beach Bulldozing
Other
Shoreline Length f
SAV: not sure yes nc
Moratorium: n/a yesrno
Photos: yesnoWaiver Attached: yes�
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
Agent or Epli t Frinted Name
Signature ** Please read compliance statement on back of permit**
AAj pllication Fee(s) Check #
Subdivision
City ZIP
Phone# (_) River Basin 5e
Adj. Wtr. Body S V na man unkn
Closest Maj. Wtr. Body P 1 i Cn ciD u
(Scale: A11A
❑ See note on back regarding River Basin rules.
Permit
SignaWre
Iss ing Dat Expira on Date

In
- - gMetVED
JAN 25-2021
I)CM-MHD CITY