HomeMy WebLinkAbout73528D - Spires,XCAMA / )(DREDGE & FILL No. 73528 A B C
GENERAL PERMIT Previous permit#
New ❑Modification El Complete Reissue ]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 I SA NCAC 07 N . 11 O Q)
❑ Rules attached.
Applicant Name K£Atxr- A 2e MARTHII aeMr 5
Address I k j 2- 0rFS1%r„zr--- ^I'R�vr_
City EAYrTTr-..1 L,i r- State ZIP 2 S 3 o S
Phone # - all
Authorized Agent C?RCCn FICDL,0EA/
Affected
AEC(s):
ORW:
XCW ❑ EW ❑ PTA XES XPTS
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS:
yes no PNA yes
Project Location: County RRL, At ('J t cy-
Street Address/ State Road/ Lot #(s) 117
MAP 1.-1 A/ DR,,, r-
Subdivision --
City 1A0t-0 F-,J 13f Act-t ZIP 2 S4GA
Acw N ; Phone # ( 110 ),54o - & 510 River Basin L &tKRr-F-
Adj. Wtr. Body CAAf,4L- (nat /i��)
Closest Maj. Wtr. Body At W W
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Type of Project/ Activity F2>L-P1. A c C. 'gw.1 A cA o 2 W A'7£Q.vA n OF
5X t s-r i /N ci Q t -%. % G At MEnl7 (Scaled A = 20 )
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Fixe
Float
Fing
Groi
ulk
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Boat
Boat
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A building permit may be required by: OODC.i $EAC-A ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) p
Notes/ Special Conditions 07P. 1100 & Au- O-rl{ER LO CA L - STATE .0 AAIO
Fr'D£RAi- RLFut-A 7 10^/S APPLY.
X.
Agent or
`-lig� Ore lease read c� lance statem back opermit
It - 3.5 58
Application Fee(s) Check #
TA -
Permit Officer's Printed Nye .
Signature
4 12 /11 g112 A
Issuing Date Expiration Date
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■ Complete items,,t,4-+d 3.
■ Print your name'andv0dress on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
�/ 1 7- q J
r%OD Xmne-j C4 ,
14Pe-y u , e- ZI ro;I,
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A. Signature
X ❑ Agent
❑ Addre
B. Rec by ( noted Name) C. Dat of Deli
4 ^ act. E�
D. Is delivery address different from item 1 Ye
If YES, enter delivery address below: ❑ N
3. Service Type
❑ Priority Mail Express®
I
I I
I
I III'I
I II
II
II I
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I II I
I III
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❑ Adult Signature
❑Registered MajjTM
❑ Adult Signature Restricted Delivery
❑ Registered Mail Restricted
9590 9402 3258 7196 8511 99
❑ Certified Mail Restricted Delivery
❑ Retum Receipt for
❑ Collect on Delivery
Merchandise
2. Article Number (transfer from service labeq
❑ Collect on Delivery Restricted Delivery
❑ Signature ConfirrnationT
7 018 113 0 0001 3358 7534
❑ Insured Mail
❑ Insured Mail Restricted Delivery
❑ Signature Confirmation
Restricted Delivery
(over $500)
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
I
Date Received
Date Deposited Check From Name
Name o1 Pe —If Holder
Vendor
Check Number
Clack
amount
Permit NumberlCommenfs
Receipt w RMund?teallocated
Column)
Column2
Column?
Column)
Ce1umn5
Column8
Column?
Column8
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4 01
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Bank
GP# 3 8