GP68699A_General Permit_20180409

C9
jA fk/Lr DflEDGE IS FILL q
GENERAL PERMIT IPrinted ri6#1 B c D
arm #
I�New Orrialftication flCornpkctseRmdsaue UPartaRvissumer Date primary psuetl
A¢auinterior by the 5utee( Nonb Camllna Defendant of Emtronmem and Natural Rrsoi I7 P 0 .
and the Centel Rmouraea Comml6ebn in an area at ... rermi mourn puteuant is 15A thi
nna.
Applicant Name I at T ..L� „n b" Project Location aunty '0 r
Address /I M, ) �- Q I Street Arl State NEW Lot#(a
City kll Pe V� lbyly gmt N' i A'i >r/1nuL' Roy C
Phone #(<)Si?)G53 i—
(J d7.E-Ma. —. SubdivisionC Dfal a y S.
Amhores"ent K nt, sr t.,,,I. (sIt (Day k`(l p_ (',/ /✓; //s _. ZIP
Affected Etches idbEw rRbrA DES i Phone# ( ) Bear Basin
AECP). PCrEA Dews, flail I111H IItu MWA All. Wtr. Body
OW yea ekom Pri yet /(ao Closest Maj. Wed. Body 11( n .r nr f n n
type of Proll Activity
C as5Y)"r.
rA
Ja X
tysS
-1),,k
byba
am La.n
m
(Scaler
r, y ( 1 ch
nv(ea[m myth""
Grobe
ase
f
M1
cover Accurate .e �ni
A heading pei may be regatred
(Note Local Planninglunsdl<tloo
Notice AllCm illene
camea .
RlvorB
aw
.�.
❑seemata
uM
re6vtling
,
by'.. i
aerpe.hl
FFmlkiMp
libaP
M
r
n leNbl
i
VIW yy(