50429_PARKS, DAVID_20080507

CANIA71tDREDGE & FILL %r L
GENERAL PERMIT Previous permit #
XNew DModification El Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources -• , r_r�
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC L 1 1 t { ?
W Rules attached.
Appticant;Name Project Location: County ! C't
Address, - � i t ' `. . Street Address/ State Road/ Lot #( )
Phone # (�`�.J1� Fax # ('�1^Z_ Subdivision L.l C 1.
AuthArfzed Agent City ZIPS
❑ CW ) 4L-W MPTA 1$ES [IPTS Phone # (_) River Basin=man
t' � i'1 L.
Affected 0 OEA El IH UBA ❑ N/A
AEC(s): Adj. Wtr. Body Lt ClY I unkn
El PWS: AFC:
/, i-� Closest Maj. Wtr. Body Q� «
ORW: Yes /S no' PNA yes /{ no; Crit.Hab. yes no ! ,
v , .
■ ■■■■■■
• • • ■■■■■MEMO ■■■■■■�����MMEN No
INN I ON
... • ... - :
..
1t!'�
ON
ME■■■■■
.
■■
N
►•�■■■■■■■■
tom!
■
■■!i
:
■■
■�!■■
■■r�■■�■■a�■►�■■■■■■■■
■■ii■■■■■■■■■■■�■■■�■■■■■\■►V■■■■►II►LI■
■1■■1
al
MI
■■■
■■
t�■■■-'
■
■■■III
i■■IIfEli'
Jim
0
it
■■
■■
�MEN
��N'��
Agent or Applicant Printed Name Permit ffice s Si lure /31 t
Signature ease read compliance statement on back of permit ** I' uin Date ' � iration Date
Lah
Application Fee(s) Check # Local Plannin Jurisdiction Rover Fife ame