59926_OLD, LINDA_20120228

L7CAMA/ ❑DREDGE & FILL
G E N 17= RAL ERMIT Previous permit #
I ,N.ew Modification ❑Complete Reissue El Partial 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 I SA NCAC
Rules attached.
Applicant Name Lj,n � G Q Q
Address �' T> 1� y X 3 6
City t-&p u �-k State f.! C ZIP
Phone # (dam) aO'+ - 3y39 Fax # (_)
Authorized Agent CC pp S Ma r nw Co..54 ry �. E
Affected ❑ CW � EW �( PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes /9) PNA yes /;iio- Crit.Hab. yes
Project Location: County Our r . � ,.> c, V
Street Address/ State Road/ Lot #(s) �) 3 1- Pc',
Subdivision
CityMa-/pc 1C-
ZIP ao-4 S V
Phone # ( )� River Basin
/P�
Adj. Wtr. Body C{r� �.r[ k -r` �natJman /unkn)
Closest Maj. Wtr. Body C,,,Y t Ai c-K 70 r c
Signature ** Please read compliance statement on back of permit Issuing Date Expiration Date
Application Fee(s) Check # Local Planning Jurisdiction Rover File Name