Stone, Charles - 88973C

❑DREDGE & FILL Na 88973 A B C D
GENERAL PERMIT Previous permit
Date previous permit issued i 1
❑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 ' ❑ Rules attached. W'General Permit Rules available at the following link: www.deq nc gov/CAMArules
Applicant Name
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Authorized Agent. '
Address
Project Location (County):
City
State
ZIP
Street Address/State Road/Lot #(s)
Phone # (_)
Email
Subdivision
City ZIP
Affected ❑ CW
❑ EW ❑ PTA
❑ ES ❑ PTS
Adj. Wtr. Body i.'.r, 'I, {';. i : L. (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: )
Shoreline Length
Access Length -
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-.
_
Pier (dock) length
-
Fixed Platform(s)
-
L
-
-
-
I
Floating Platform(s)
Fin let(s)
er P g
Total Platform area
Groin length/it
Bulkhead/Riprap length
Avg distance offshore
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Breakwater/Sill
Max distance/length"'
Basin, channel
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Cubicyards
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Boat ramp_r
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Boathouse/ Boatlift
Beach Bulldozing
Other
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-
SAV observed: yes noMoratorium: n/a yes noHN
Site Photos: yes no
Riparian WaiverAttached: yes noL
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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
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT (Please Initial)
f
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name-
.. �/rs
Signature**Please read compliance statement on backof permit** Signature
J
Application Feels) Check#/Money Order Issuing Date � Expiration'Date

❑DREDGE & FILL N° 88973 A B C D
GENERAL PERMIT Previous permit
Dateeprevious permit issued
❑New ❑Modification -bCompleteReissue ❑ 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 Rules attached. Ll General Permit Rules available at the following link: mLw.deq.nc.gov1CAMArules
Applicant Name
Address I
City 1 - State ZIP
Phone # (_ )
Email
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ 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: )
Shoreline LenRth
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A building permit/zoning permit may be required
Permit Conditions
CRC RULES
Agent or Applicant PRINTED Name
Signature "Please read compliance statement on back of permit'*
THIS
Application Fee(s) Check#/Money Order
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
i
Permit Officer's PRINTED Name
i
Signature
,2�
Issuing Date Exp ration Date