Lawhorn, Steve 78968C

CAMA / ❑DREDGE &FILL
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�Lk N9 78968 (2)
-. GENERAL PERMIT
A B D
Previous permit #
Alew ❑Modification ❑Complete Reissue ❑Partial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality /� p
O�i/ co
and the Coastal Resources Commission in an area of environmental concern pursuant
to 15A NCAC /�
❑ Rules attached.
Applicant Name 0 rA
Project Location: County 0 510 ry
Addreccss
I �G' l%
Street Address/ State Road/ Lot #(s)
City J �� State ZIP
Phone # R1 E-Mail f�
Subdivision
Authorized Agent
City ZIP
W W *VTA S ElPTS
._Je-e-''� `
4
Phone # ( ) River Basin Joe
Affected
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body t man nkn
❑ PWS:
ORW: yes / PNA (yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length_
Fixed Platform(s)
Floating Platform(s) n 1'
Finger pier(s) *^
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards _ s
Boat ramp
Boathouse/ Boatlift--_`...._...
P �
Beach Bulldo 'ng ----
Other S 1
Shoreline Length , L�
SAV: not sure yes no j----
Moratorium: n/a yes
Photo .
Waiver Attached: ye no
A building permit may be required by: \.
( Note Local Planningjurisdicti )
Notes/ Special Conditions
i � S �•
P't'ri-g7p 017
ge ' or Applicant Printed Name
Tgpature **&ase read compliance statement on back of permit
Application Fee(s) Check#
� t
(Scale:
❑ See note on back regarding River Basin rules.
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PermitOfficer' anted N e
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Sig a re
Iss ing ate Exp' ation Date

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