HomeMy WebLinkAboutGilbert, Gerald 88940CAAA CO"r4 QCAMA ElDREDGE & FILL N9 88940 A B C C
a GPrevious permit
GENERAL PERMIT
Date previous permit issued ,
El 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:
I SA NCAC ( j f / r r ' ❑ Rules attached. 0 General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address (?.rw
City State jZIP
Phone #
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑CW
AEC(s): ❑OEA
ORW: yes/no
EdEW ❑PTA
IHA UW
❑ ❑
PNA: yes/fio'1
❑ES ❑PTS Adj.Wtr.Body p; `�;, •„ ,t'•�l4'1C� (nar/man/unk)
SPIMA PWS - r i
❑ ❑ Closest Maj. Wtr. Body
Type of Project/ Activity
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(Scale: )
Shoreline Length
Access Length
Pier (dock) length
Fixed Platform(s) -.
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Floating Platform(s)
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Finger piers)
Total Platform area r`� _, <-L� .- i
Groin length/# /
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Bulkhead/ Riprap length !' ;-
Avg distance offshore %
Breakwater/Sill ..�' -
Max distance/length
Basin, channel --• / --
Cubicyards
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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 'r rt!'(r
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Y O"F ❑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 PROJECTAND 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
Apollcation Feels) Check N/Money Order Issuing Date Expiration Date
o1*diCOM741&ECAMA El DREDGE & FILL N9 88940 A B C D
a GPrevious permit
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 I �-J ,, 2-Cl t T❑ Rules attached. �4 General Permit Rules available at the following link: www.deq.nc goy/CAMArules
Applicant Name
Address r < 0\ 1
City @Y 14CV r_ S(IVV�State zip j
Email lrRti VI CLCI i"',(li l Cr-y-y\
J.,
Affected ❑CW WEW
AEC(s): ❑OEA ❑IHA
ORW: yes/no PNA:
Type of Project/ Activity
Shoreline Leneth
Authorized Agent
Project Location (County): E[IY4e r t'
Street Address/State Road/Lot #(s)
Subdivision
City llr,.t
,N PTA ❑ ES ❑ PTS Adj. Wtr. Body '.. ' l 1 Vl(I (nadman/unk)
❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body
(Scale:
Access Length
Pier(dock) length
Fixed Platform(s)
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Floating Platform(s)!'TT
Finger pier(s)
Total Platform area �� r('
Groin length/#
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Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill /
Max distance/length
Basin, channel
Cubic yards -'—
Boa[ ramp
Boathouse/ Boatlift
Beach Bulldozing
Dther 1._ 11 I 1I I tr r
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iAV observed: yes no —_...r
Moratorium: n/a yes no
iite Photos: yes no- -(v)
tiparian Walver Attached: yes no iUyy..
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A building permit/zoning permit may be required by: ( 'n -
Permit Conditions Ito irll <tl f"'{1 r +"1' (+
❑ TAII/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
Feels)
Check tt/Money Order Issuing Date
Expiration Date
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N.C. DIVISION 0? COASTAL MANAGEMENT
AD.,ACENT RIPARIAN PROPERTY OWNER NOnriCATION/WARVER FORM
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A DJACINT RIPARIAN PROPFRl (l.WhjR E CERT:FICATICN
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WAIVER SECTION
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