Hill, Matthew (2)

®❑CAMA / C DREDGE & FILL Nd 74972 A B C D
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Comi ni lion in an area of enviro me tal concern pursuant to 15A NCAC / / 1,
1 ❑g s attached
Applicant Name i I \�J" try ('i Project Location: County / ,f'G y
Phone # ( )) 3 /fv
Authorized Agent
Affected ❑ Z
AEC(s): Li
,- p PWS
ORW: (yes /; no
II* j'<PTA ❑ ES ❑ PTS
❑HHF ❑IH ❑USA ❑N/A
PNA yes / n�l
Street Address/ State Road/,Lot #(s)T
Subdivision
CityZIP_
�! t �" > 7
Phone # O _ iver Basin
Adj. Wtr. Body _ 4 / ' < " ' ,Anat /man /unkn)
Closest Maj. Wtr. Body— al
ON
IN
MONMEMENE
0
0 ME OEM
■■■■■.Is
■ .■� ■■.
■■.. ■■■-_■..
mom �■._■■
■■ ,■■■�■ti■.�
■■■■■■
am mom
■�®■��.�■■�M
r3O!i
-M
In
■li■■G■■
■■■■■■
■■
■■■
■■■
■■■
■■
■■
■
■■
■■�■■
■■■■■■
�■■■ME
■�■■�
MEN
on
ME
ME
®■■
��
■■■
■■■■■
■
■
it
■MW-
■
ME
VA
I
IN
mom
���
■■ ■■ ■ ■
.. ■i■■
■�■11�� ® ®■■■O■
�i■■■�,�li■.■■■■
...®i■■�
.■■.■■■■■■.■
■MINE■■■■■■■■■■■■■■■■■
• ■■■
■■ .■■ ■■■®■
.■■■■■.■■� ■.. .
mom i■■
■■r°■■■■■■�i
■■■■ �si�ri■■ii■
ON
ME 0 ei1 IN
I �I■■rI n■0■■
■■■■�■■■■
■■■■■i�■■riiil�■!�P�■■■%■■\�0�7■■■
■���M:C�C��
®G:ME
:ME
Agent or Applicant Printed Name
4.
Signature "Please read compliance statement on back of permit"'
Application Fee(s) Check#
PermitOffcer's Printed Name
Signature J
Issuing Date .7 ' �xpir'ation Date