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Heath, James
Q'GENERAL CC�� 4A z-rk.�l *+ s:sr! mate pr"v cw fh9.:'#ikrNN.-4,e4J by i�':+: `',` N. Y£�k _ Y.. Cr•r7:3, i t..l7 xp tkf '['k rit $i ld%3EktY } _h eti C es: � gn •t ,r+ k� f c t r;v rcxzerseza^a, .t e1 €°r7b rtz, sssas;x ts� 95t� NC �C � _•,_. MY �E Street Address' State itoa L. 8 z 4 �S•. _ a� ooi i.,.,f... .. _4� ul cps " ��•" - .�, x? R ^ � i 106 "RR f kfh -� �(CAMA / ❑ DREDGE & FILL � �) " "� 142 A B D GENERAL PERMIT Previous permit# 74-7 ❑New ❑Modificationomplete Reissue El Partial Reissue Date previous permit issued ✓ 2�? 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 07 �, � Rules attached. Applicant Name AMP.,S pea 1"l Project Location: County On-s Low Address v �% l� 11� Vt P� .1� C 1 ye, Street Address/ State Road/ Lot #(s) StateZlP� Phone # r(jO )�71;,1'/(Q.fJJ E-Mail Authorized Agent Affected A_CW AEC(s): ❑ OEA ❑ PWS: }'EW PTA XES ❑ PTS ❑ HHF ❑ IH ❑ UBA ❑ N/A ORW: yes /nn PNA 0/ no Type of Project/ Activity p�© Pier (dock) length Fixed Platform(s) X Floating Platform(s) Finger pier(s) 2 / Groin length �^ number r Bulkhead/ Riprap length avg distance offshore r max distance offshore r Boat ramp aoat� h oa iK x A building permit may be required by: ( Note Local Planning jurisdiction) Notes/ Special Conditions �Printed Agent or me Signaf ree ** Please read compliance statement on back of permit" Application Fee(s) Check # VA Subdivision City ZIP Phone # () River Basin UAAv_� Adj. Wtr. Body_ an unkn ,�,m P s Closest Maj. Wtr. Body � �c _ (Scale: IV11 ) ❑ See note on back regarding River Basin rules. Permit Office 's Printed ame All Signature Iss ng ate xpir tion Date NC Division of Coastal Management 2 J A B D Cashier's Official Receipt Date: 20 $� Received From: c Permit No.: t 7� 3 1 ,� L Check No.: Applicant's Name: County: Project Address: Please retain receipt for your records as proof of payment for permit issued. Date: Signature of Agent or Applicant: Date: Signature of Field Representative: LCDR James A Heath USNR (RET.) - w . 275 Grandview Dr s - Sneads Ferry, NC 28460-7530 usA " FortEVEn A C vi-on of Coas b I ,M an'a 0A64 � Atfn. BradConntdi ,�04 Cornm� r'ee l� ir��u orelaC ����J �� 2g�J 11,I1]1111111111111fjldl-iilllfidIIfl„lillrlilllJiil'111111,11