Tyson, Dustin 88515C

❑DREDGE & FILL
GENERAL PERMIT
( New ❑Modification ❑ Complete Reissue []Partial Reissue
N® 88515
Previous permit
Date previous permit issued
As authorized by the Stat7 f Nortt Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC 'r J CZ ` 0 ❑Rules attached. 14
General Permit Mules available at the following link: wwwdeg nc Psv/CAMAru
Applicant Name
Address
City
Phone # (_ )
Email
ZIP
Affected ❑CW ❑EW ❑PTA ❑ES ❑PTs
AEC(s): ❑OEA ❑IHA ❑UW SPIMA ❑PWS
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)'�
Finger pier(s)
Total Platform area
Groin length/N
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/length /I
Basin, channel'
Cubic yards
Boat ramp
i'Boathouse/ Boatlift �i �� flo L,0
Beach Bulldozing
Other
i
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached:
A building permit/zoning]
Permit Conditions i
i'
yes no
yes no
yes no
yes no
may be required by:
C-
Authorized Agent
Project Location (County): K t,
Street Address/State Road/Lot#(s)
Subdivision f/
City ZIP
Adj. Wtr. Body
Closest Maj. Wtr. Body
)Scale!�`�� )
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 PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name -\ Permit Officer's PRINTED Name
Signature.'* Please read compliance statement on back of permit" Signature
Application Feels) Check #/Money O der Issuing Date Expiration Date

❑CAMA ❑ DREDGE & FILL N9 88515 A B C D
Previous permit
GENERAL PERMIT Date previous permit issued
1,MNew [:]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: wwwdeq.nagov/CAMArules
Applicant Name _
Address
City
Phone # (_ )
Email
Affected ❑CW ❑EW ❑PTA
AEC(s): ❑OEA ❑IHA ❑UW
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Project Location (County):
P Street Address/State Road/Lot#(s)C. f
❑ ES ❑ pTS
❑SPIMA ❑PWS
City
Adj. Wtr. Body
Closest Mai. Wtr. Body
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A building permit/zoning permit may be required by:
Permit Conditions
e
FTAR/PAM/NEUSE/BUFFER(circle one) .
❑ See note on back regarding River Basin rules
See additional notes/conditions on back
1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please lnitiol)
Agent or. Applicant PRINTED Name Permit Officer's PRINTED Name
Signature^*Please read compliance statement on back of permit" _ ♦♦♦ Signature
Application Feels) Check q/Mo.(ney Order Issuing Date Expiration Date