5X780_TOWN OF CAPE CARTERET_20080516

li-dAMA / 1-1 DREDGE & FILL
GEWERAL PERMIT
N.T0 t-1 17 V U(
/revious permit #
-(4-
[K]Me';� ElModification ElComplete Reissue E] Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and NaturaFfkgiources
and the Coastal Resources Commission in an area of environmental concern I pursuant to I A NCAC ®-Rules attached.
Applicant Name
Address
City State ZIP
Phone # Fax #
I a
Authorized Agent
PTS
Affected El Cw 0 EW El PTA F] ES El
AEC(s): 0 OEA 0 HHF D 1H EJUBA EIN/A
El PWS: El FC:
ORW:: yes / no PNA yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone# O River Basin
Adj. Wtr. Body (nat I
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
Pied (do:ck) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length—
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
ShorelineLength
. ! :TT
SAV: not sure yes no
Sandbags: not sure yes n i
1—tom"—
Moratorium: n1a yes
Photos: yes f ono
Waiver Attached: yes nd-
A building permit may be required by:
Notes/ Special Conditions
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kill
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❑
See note
on back
regarding
River Basin
rules.
Agent o,�, pplicanf Printed.flam6
1-4
Signature' Please read compliance statement,on-back of permit **
Application Fee(s) Check #
PermitOfficer's Signature
�7
Issuing Date Expiration Date
Local Planning Jurisdiction RoverF