73513D - Schilawski

,XCAMA / A DREDGE & FILL
GENERAL PERMIT
,New Modification ❑Complete Reissue ❑Partial Reissue
No. 73513
Previous permit #
A B C 0
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 D 7 Fk , I I oo Sr 12-oo
I-1 Rules attached.
Applicant Name cmAr_L & ZIuLIL° SCHIL 4WSK1
Address 1028 WASHWGToA/ S-r
City Alty State XC ZIP 27 5
Phone # (qI ) 740 - 447 G G E-Mail
Authorized Agent 0REfy E-iobDF_^!
Project Location: County 9Rtk,4S W I C-K
Street Address/ State Road/ Lot #(s) 142
DO LP y/ DF-1 V E.
Subdivision r/ /A
City 1AOLDEA/ 13r_Ac-K ZIP 294 (c 2
❑CW )(EW
gPTA XES )(PTS
IlearAIT Phone # (910) S40- is 510
River Basin LLkMtSF_w_
Affected
❑ OEA ElHHF
AEC(s):
❑ IH ElUBA ❑ N/A
Adj. Wtr. Body CA IVA L.
(nat man /unkn)
L, PWS:
ORW: yes / no PNA
yes / no
Closest Maj. Wtr. Body A I
W W
Type of Project/ Activity
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A MAX I MtA tA
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wArcRwAfty
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at
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Boad
Bead
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avg distance offshore
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distance offshore 5
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Are Length 0
not sure yes m
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torium: yes no
ms: yes
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A building permit may be required by: V101.DE.n/ 13CAC-0, ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions 07 N , It 00 & , 1 200 AgD A Lit. 0T1`1t;R LOCAL.
STATE /WD Fe DER ^L ;zF_4& A"-rP .J APW _
I�eV1
Agent
Suture **Ul ash read compliance statement on back of permit"
Gov v - 3521
Application Fee(s) Check #
Permit Officer's Printed Name
�t
G
Signature
3 27 19 -1 Z7 19
Issuing Date Expiration ate

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Date Received
Date Da sited
Check From Name
Name of Permit Roder
Vendor
Check Number
Check
amount
Perrrdt NumbenCo fs
Recel for Refund/Reallocated
Column!
Column?
Column3
Column)
Column3
Column6
Column?
Column3
Columnil
k ald BulkhgftWhael
M 10.l.—k.3521