20140322 Ver 2_CAMA Permit - Reissue_20171027

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Previaus permit # ',;,���"�'
C-]New ❑Modification Camplete Reissue ❑Partial Reissue Date previous permit issued r� �� �i
As authorized by the State of North Carolina, Department of Environment and Natural Resources � �
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �% r�„ ���
❑ Rules attached.
Applicant Name �� �� _ ___ Project L.ocation: County. ���
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Address � �� ���' "i � • �s ��� ___ Street Address/ State Road/ Lot #(s)��`r ,,,;�. ,� ��,�„W_C,�_���
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CitY_ ��'__� State_� ZIP� �m " � . �°@_ �'+1 i ` ��► �'�
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Phone # w �
i - E-Mail , ^" � �r � � Subdivision �^"""""
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Authoriaed Agent _ _ � -- �� City���,��1� _. ZIP ���" �
Affected n Cw ❑ EW 7'A ❑ E5 C°�i'S Phone #( _). "'� River Basin �}��,r.�t
AEC s : ❑ OEA ❑ HHF ❑ IW ❑ U@iA ❑ N/A � ���� •y .�
� ) Adj. Wtr. Body , ��,,,, � � ^" nat man_../unkn
❑ PWS: - - ��
�, °� Closest Maj. Wtr. Body.----1.�f�"=�aS �t`.��'__
ORW: yes / no PNA yes /�:,.y✓ --
Type of Project/Activity ����'�" �,,�;i�T'�1��� �'i�,i (�"��. t.�'1'7'�~ �,y�t� ���G� "D� 1 `� p�- ���'f.�
�� � � � � l � ���"/y1 � ,.�... (Scale: P«�'ll,� )
Pier (dock) length_ �^^°^`
_ _. ... .
Fixed Platform(s) . "� -� � _ � �� � - - � � ! -�� � i 9 � � � �
Fioating Platform{s) _ """"'" _
Finger pier(s) '^'"'"'
Groin length ^^–r~
number °"""
Bulkhead/ Riprap length "'"'"'�"
avg distance offshore �"°"
max distance offshore ^�°
Basin, channel
cubic yards-- " , . .'
Boat ramp
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Boathouse/ Boatlift ""'��" -
�,"`r _ ,
Beach Bulldozing ,
Other��_ i� �_� �. �"�
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Shoreline �ength �,�ltl �
SAV: not sure yes no'
Moratorium: n/a yes o�
Photos: /°°q�"s � no
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Waiver Attached: yes no .
A building permit may be required by:
( Note Lacal Planning Jurisdiction)
Notes/ Speeial Conditions
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Agent or lica in , rpe ,i
���f� t'"c�« ❑ See note on back regarding River Basin r-ules.
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Si�natu"re '�� Ple�se read compliance statement on back of permit �`*
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Application Fee(s) Check #
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PermitOfficer•'s Printed N�„
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Signatur � � � �
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Issuing ate • Expiration Date