55981_LANDER, ROBERT J_20110315

t� CAMA / 11 DREDGE & FILL
EN RAL PERMIT Previous permit #
lew Modification ❑Complete Reissu�fartial Reissue Date previous permit issued
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 i
Rules attached.
Applicant Name i2 } r 3. Lc r
Address -4O'�6 Cs.urr,A� c.14 9 �
City k,- �%%t,!C Statef,)L ZIP A3gHeF
Phone # ( A) -4 flip ! Fax # ( )
Authorized Agent Fi n t k r_ n N {' _j T n
Affected E] CW gEW PTA ❑ ES ElPTS
AEC(s): O OEA 0 HHF ❑ IH ❑ USA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / Oo PNA yes / 6o- Crit.Hab. yes /
Project Location: County 1:)4 r e
Street Address/ State Road/ Lot #(s) -qb S�,,,,1.;� k r2
Subdivision+
City Y- J i'V Fl a w it ZIP
Phone # (�4'_) = ;-�'J, ! River Basing . Y
Adj. Wtr. Body k, C(haJman /unkn)
Closest Maj. Wtr. Body 50 � A
t
Signature' ** Please read compliance statement on back of permit" Issuing Date Expiration Date
Fob is 1,
Application Fee(s) Check # Local Planning Jurisdiction Rover File Name