New Bern, The City of 77110C

OA I tli� : -,
GE & FILL D
PERMIT Pr�vious pern-pt
mew Pladi6catron Complete Reiswe Parual Reissu- Date prevtous permit tssued
"M ailtho-zed by ttiv State of North Carofina, Departowu f nvironn----,,- t4�,mv,,
"ll the coasul Ronources Commission M an ar KA,,If d K(j
mu*wo-
ApWiCint Name,
Address lot
Coy
Phone
Atithor4zed Ahv City
5 cw rEw -,'PTA ys PTS Phone #
OEA WO W UBA K A
1\ "i wtr Body
closest Kq Wv. &Ody
ORW PNA
(UAW
F1

XCAMA / ❑ DREDGE & FILL �("7L N9 77110 A
GENERAL PERMIT Previous permit#
."ew ❑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 0.7 J4Je_---,vC0��1
—�( M- Rules attached.
Applicant Name I 1 O Project Location: County t;y r
Address Street Address/ State Road/ Lot #(s) V �0
City / V State��ZIP f�
Phone # r E-Mail Subdivision
s
Authorized Agent
❑ CW
--trfW-
PTA ❑ ES ❑ PTS
Affected
❑ OEA
❑ HHF
❑ IH ❑ UBA ElN/A
AEC(s):
❑ PWS:
ORW: yes �
PNA
yes / no
Type of Project/ Activity
5
r
Pier (dock) length%24_
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore r
max distance offshore -e'
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
i
Beach Bulldozing
...__ — ._....... _._..__
Other
Shoreline Length
SAV: not sure
yes--r-
Mno
I
Moratorium: n/a
yes
-Photos.
e
Waiver Attached:
yes Uno
A building permit may
be required
by: Ali'
( Note Local Planning
jurisdiction)
Notes/ Special Conditions
1114
IvItT
Agent oQppUi wIt Printed Name
Si nature ** P ease read compliance statement on backof permit **
= 7L7
Application Fee(s) Check#
B (:�) D
City ZIP
Phone # O River Basint
Adj. Wtr. Body tBo&
/ n t man unknClosest Maj. Wtr.
.S
(Scale: / - 10
❑ See note on back! regarding River Basin rules.
FGaa COME
Permit Officer's Printed N
Signat re %
7
1 s ing D e Ex iratio ate