Harris, Robert 88401C

a�cournr i tE) LY�3`k/i)1. A B C D
s �❑CAMA ❑DREDGE &FILL
GENERAL PERMIT Previous permit I
� Date previous permit issued .
❑ New [:]Modification E] Complete Reissue ❑ Partial Reissue
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:
ISANCAC
I ❑ Rules attached.
K❑., General Permit Rules available at the following link: v✓vwvdegnc.gov/CAMArules
Applicant Name f ,J ) 0 1 J" s d ((. t 1 ( t9
Authorized Agent i - (�
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Address
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Project Location (County):
City
State r 4 ZIP i.1 (�% (`i
Street Address/State RoaclUt#(s)
Phone # (_)
Email i
t 1 '.i ��'�-� ( �.a ��
Subdivision
._�
City ZIP
Affected
El cW ❑ EW 1'PPTA ❑ ES ❑ PTS
Adj. Wtr. Body ' -S (? ---"- ^--'' 1
(natman/unk)
AEC(s):
❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS
Closest Maj. Wtr. Body,",�j�'�
Type of Project/ Activity
(Scale:
MEN
■■■;
■:;;;
ME
No.::
■.�.
Floating Platform(s)
■
r
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.
■
.
■■
Bulldozing
�ti
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r!■::ON
on
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■
■:■®■
ni■■■
■■■
ME
NoIF
■■d
■
■■■■:ME■:■.
■Beach
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
■N�■;.■
MEN
:■■■.:■
■■■■■■■
ONE
MEMEMIN
A building permit/zoning permit may be required
Permit Conditions
(..�- TAR/PAM/NEUSE/BUFFER(circle one)
1 See note on back regarding River Basin rules
See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
i
Signature "Please read compliancre statement on back of permit" L! I (� Signature
Application Feels) Czheck,*/Money Order Issuing Date Expiration Date

sAtom" LICAMA ❑ DREDGE & FILL A0 88401 A B C D
€� Previous permit ,
GENERAL PERMIT Date previous permit issued i `=
❑New ❑Modification [Complete Reissue ❑Partial Reissue
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 ❑ Rules attached. General Permit Rules available at the following link: wwwdeg nc eov/CAMArules
Applicant Name _ d "
Address
City
Phone # ( )
Email
State ' t zip ( ( i i
Authorize Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City M I > ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTs Adj. Won Body ' (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Mal. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:
NMI—■■
:
■
■
..
H
■
ME
■
■■
■
H�j
■■■..■■.■�.■.■..■■�H■■■■■■��:::
MEN
�■.�®�0�sm
fl�
■
Floating Platform(s)
Ems
NJ
Finger pler(s)
C■■■■III
:.. ,.
e■■■i■■■■
■�C■
■I
N■iC■i'iC.■mi
r■vMEN
ME
■;�
Ems
Iq■�H■gN;;iMEMS
■ENH■■■E■■/I■
■■■■■■■■■■■■■■■■■■■■No
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F
MOM
ME
II
I
Is
I
■EN�■�■Off■��
■■
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■■■■■■■■■■
ONES
■■■■■■■■■■■■■
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MENE■;■■;�!
■■
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Ems
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A building permit/zoning permit may be required by:
Permit Conditions
TAR/PAM/NEUSE/BUFFER(circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROIECTAND REVIEWED COMPLIANCE STATEMENT.
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "*Please read compliance statement on back of permit"* Signature
i
Application Feels) Check q/Money Order Issuing Date
(Please Initial)
Expiration Date

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