NC Aquarium

ElCAMA / _ DREDGE & FILL No. 73467
GENERAL PERMIT Previous permit #'7A;; B (c D
[]New ❑Modification Complete Reissue El Partial Reissue Date previous permit issued /
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to ISA NCAC
E�lRules au
hed.
Applicant Name ` i I 10 1 i 't 1 i iLt i I!r lProject Location: County / 1 t /
( �
Address Street Address/ State Road/ Lot #(s)
City _ State ZIP
Phone#( ).'j % /�/C E-Mail Subdivision,
r ,, I > t.t /�/1 City -ZIP
Authorized Agent 1 F ( '
L'S,.CW NEW PTA ES ❑PTS Phone ( ) River Basin
Affected ElOEA ❑ HHF ElIH ❑ USA ❑ N/A
AEC(s): Adj. Wtr. Body 1 ' >.'rl If n,'; (nar/man /unkn)
ORW: yes / no l PNA yes / no Closest Mal. Wtr. Body
--
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit Officer's Printed Name
Sig/te''%I
Issu ni Date xpiratk:6 Date