Dockside Yacht Club Inc. 88524C

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J. V,G N G f'1I'�I�L P E l V 11 T Previous permit
Date previous permit issued
(New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Cxolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC c ❑ Rules attached. General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name Ltd' _ t fib t' �.F. r.
n.
Address �`
City # ol�7; tate
nL ZIP0-53;
Phone #{A
Email
Affected ❑ cW --PQEW' PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS
ORW: yes/no PNA: yes/no
Type of Project/ Activity o 4.
i
Authorized Agent f Jw
Project Location (County): _
Street Address/State Road/Lot #(s)
ate,.
Subdivision
City _ ZIP
a
Adj. Wtr. Body
Closest Mal. Wtr. Body
S
rr
l �)
aF
- � Scale
Shoreline Length ✓ ~�t, r',
Access Length
Pier (dock) length
Fixed Platform(s) Z,
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp '� p
Boathouse/lBoatIV x
Beach BuA
Other
SAV observed:
yes
t
Moratorium: n/a
yes/5'
d
Site Photos:
yes
`s no i.
Riparian Waiver Attached:
yes
4 not
A building permit/zoning permit may be re(
I AM AWARE STATUTES,gfCRC RULE
ig or Applicant Pnd R�1�EfgLlyame
THAT
compliance statement on back of permit"
AND REVIEWED CC
I
Permit Officer's F
SignnaatuP
�r
❑ TAR/PAMINEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
STATEMENT,
cation Feels) Check`#/Money Order Iss'birig Date Expiratict Date