Barnhill, Chris 76778C

X-!9 AMA / ❑ DREDGE & FILL J N�-) 76778 A B DID
N ERAL 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 Q
Rules attached.
Applicant Name 4 Project Location: County o C"
Address Street Address/ State Road/ Lot #(s) �V
City State C ZIP
Phone # ff a) 5 - q9773 E-Mail Subdivision
Authorized Agent ,�19�,/- (iti ��' City ZIP
Affected ❑ CW ,AaTW .A-IrTA ❑ ES ❑ PTS Phone # ( )
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body 1 �i �/
ElPWS:
('Incact Mai Wtr Rnrly
ORW: yes / yfiq PNA /Vey / no
Type of Project/ Activity 12 c6 �(
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards i
Boat ramp
Boathous / Boat
lift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes n --
Moratorium: n/a yes
Photos: es n
Waiver Attached: e no —
A building permit may be required by:
( Note Local Planning jurisdiction) ,
Notes/ Special Conditions InY/(_'
�v5k bar�cx
ent r Applicant Printed Name
Si at re PJgase read compliance statement on back of permit"
... C ,i
l❑�",�
Application Fee(s) Check #
River Basin
(Scale: i t® )
❑ See note on back regarding River Basin rules.
0J/ J
Permit Officer'stPr%P�PdName
Signa re
Issu ng Ifate xpi ation Date