Randles, Adam 90015C

❑CAMA ❑ DREDGE & FILL
GENERAL PERMIT
[-]New ❑Modification []Complete Reissue ❑Partial Reissue
N9 90015 A B(C)D
Previous permit
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 (- ' t ', l ) h'
'' x) • !
tl❑ Rules attached.
�eIGeneral Permit Rules available at the following link: www.deq.nc.goy/CAMArules
Applicant Name MN,.,,
Authorized Agent
Address 1I (� .�I b`f •WL
f
Project Location (County): 0,Vk_fte_
City li(-Lti, (nrl State
C
zip �(. `(,� l(t;
Street Address/State Road/Lot#(s) ,�r•; w•_,r
Phone#(`( L)13L.''7 Y', 7,/'
Email i)(A ot,m Vcknc\(B L_r
✓VN'J (CA,)
Subdivision
zip "I
City_ Be(zM f-D/f—
Affected ❑CW FEW
PTA
,®"Es ❑pTS
1
Adj. Wtr. Body i'h fco'& �_/E'L k_ (fi3Nman/unk)
AEC(s): ❑OEA ❑IHA
❑UW
❑SPIMA ❑PWS
Closest Mal. Wtr. Body_ /VOr-)ty ) t,•°'�-f
ORW: yes/c'-' PIN A: yes/l`o�
Type of Project/ Activity
Shoreline Length Id i
Access Length—
Pier(dock)length
Fixed Platform(s)—
_
-
Floating Platform(s)
Fingerpier(s)
Total Platform area;---
Groinlength/H
_—
Bulkhead/ Riprap length .. p - taw,"
.�
Avg distance offshore"r*r t� �.4
Breakwater/Sill .-"
---'N.-
�O�
6
_
�s
�
-'-
J.
/
�
Max distance/ length
Basin, channel
Cubic yardsI-
�.�I.
c
Boat ramp
f
Boathouse/. Boatlift
Beach Bulldozing
Other
SAV observed: yes no-
(
Z
C
Moratorium: n/a yes no -r
Site Photos: yes no
>
,
•---.-
._
....
,.
Riparian Waiver Attached: ,yes no'.
A building permit/zoning permit maybe required by:
Permit Conditions'•
tY�
❑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"
Application Feels) Check N/Money Order
Signature
Issuing Date
Expiration Date

AVOl'r',a .❑CAMA &DREDGE & FILL N9 90015 _ A B C `' D
GENERAL PERMIT Previous permit
Date previous permit issued '
LINew ❑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:
I SA NCAC I _ ❑ Rules attached. �R General Permit Rules available at the following link: w .den.nc.gov/CAMArules
Applicant Name "t 1, ' \ Authorized Agent
Address Project Location (County): < i
City State - ZIP Street Address/State Road/Lot#(s) -
Phone # (.)
Email Subdivision
City h:ZIP
Affected ❑ CW ❑ EW ❑ PTA _F< ES ❑ pTS Adj. Won. Body i < i._ (hat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body ',A
ORW: yes/jao' PNA: yes/no
Type of Project/ Activity
(Scale:t0 - Or 1
LengthAccess Pier (dock)
ME
2rh
■
■
�ME
■,■
■
ON
..
!
®
1[�■I/N��■■■NME
C■N,
:::
m�
�■■�
Finger pier(s)
• area
%
H
\■■■■
■■I■■NJ
■■
. ..
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
7777
Max distance/ length Ow -
mom
or
Basin, channel
Cubic yards
Boat ramp
Beach Bulldozing
Other
■®
i�■■11■Uiti®`■SAV
■■■N■�■
observed: yes no I
Moratorium: n/a yes no
Site Photos: yes no
Waiver Atta
iiRiparian
iii
ii�iirl
■
■■■
A building permit/zoning permit may be required by:
Permit Conditions`,
❑ TAR/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 Initial)
1,t
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statementon back of permit'• Signature
i
Application Feels) Check fl/Money Order Issuing Date Expiration Date

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