GP68685A_General Permit_20180322

MA / ❑ DREDGE & FILL
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PENERAL PERMIT
Previous permit#
QNew ❑Modification ❑Complete Reissue ❑Partial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and. Natural Resources
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and the Coastal Resources Commission. in an area of environmental concern pursuant to I SA NCAC
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E�r.Rules attached.
Applicant Name / cak) 1-ind 1,ri Project Location:
County "D <n r ,.
Address �. �2 r >r i` �- - 3 Street Address/ State Road/ Lot #(s)
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City Ilc.<,v c %.. State ZIP
Phone #-Mail Subdivision};;
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Authorized Agent /r,A vn 1`,._,,i y ?i c,l City Ne v
/-/, It ZIP
❑ku CW ;SEW .P_TA ❑ ES ❑PTS Phone# ("-
) River Basin vc,,
Affected
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj. Wtr. Body
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C u..'r c, ! (nat ;man%/unl<n)
❑ PWS:
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Agent or Appli[3pt-Prinfed. Name Per it Officers Printed Name
Signature **Please read compliance statement on backofpermit** Signa€ure
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Application Fee(s) Check# ' Issuing DateExpiration Date