Duffy, Michael 88934C

0 1*1WASr,&c❑CAMA ❑ DREDGE & FILL N9 88934 A B c D
Previous permit
s R GENERAL PERMIT
Date previous permit issued
New ❑ 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: www.deq.nc.gov/CAMArules
Applicant Name
Address ,
City State ZIP
Phone # ( )
Email
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
P
Affected ❑ CW ❑ EW ❑ PTA 0 ES ❑ PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale:; ,y 1
Chnralina I onoth
Access Length —
-
--
-
'-
--
I
(�f��
l
�t
i
-
i
f
-
Pier length
,
-
I
—
--
(dock)
Fixed Platform(s)
I
Floating Platform(s)
f
.-...
y.
,
W
------
- -
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length`
Avg distance offshore
,
I
Breakwater/Sill
Max distance/ length
I
;
1F
f
Basin, channel
Cubic
_..yy
Its
4
r4
1 .
l
d
yards
(
4q
Boat ramp'
L
„(�
{ c, ;(_
}
-
--
-
Boathouse/ Boatlift
Beach Bulldozing
Other -
--
L
--'
?
-
t_
t
lc
T
T—
I
-
-
_
SAV observed: yes no
t
Moratorium: n/a yes no 1 i , '
{
i
)
y
Site Photos: yes no
�.
_. __.
Riparian Waiver Attached: yes no
I V _
A building permit/zoning permit may be required by ) ♦ f_ �" C
�,! ❑ TAR/PAM/NEUSE/BUFFER (circle one)
Permit Conditions (! 1(. l i lit( S -d G
C;{ 0'}"(/1C)r t i:c t ! 7 fi" ht�'l+ ❑ 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 Fee(s) Check #/Money Order Issuing Date Expiration Date

❑CAMA ❑ DREDGE & FILL Na 88934 A B C D
y GENERAL PERMIT Previous permit
J Date previous permit issued
New ❑ 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: www.deq.nc.gov/CAMArules
Applicant Name
Address
City 1C I( State ZIP
Phone # ( )
Email
Affected ❑ CW ❑ EW ❑ PTA
AEC(s): ❑ OEA ❑ IHA ❑ UW
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/#
Bulkhead/ Riprap length
Avg distance offshore _
Breakwater/Sill
Max distance/ length_
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
( 1
❑ ES ❑ PTS
❑ SPIMA ❑ PWS
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Adj. Wtr. Body
Closest Maj. Wtr. Body
ZIP
(Scale: )
at.
❑ 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 Fee(s) Check #/Money Order Issuing Date
Expiration Date

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