71721D - Hardin

VIICAMA / ❑ DREDGE & FILL FL
ENERAL PERMIT
VNew ❑Modification ❑Complete Rei us e ❑Partial Reissue
o Previous
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Date previous permit issued I
As authorized by the State of North Carolina, Department of Environmental Quality /J 4CO47
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC r/ �� %(r/��, ��
Applicant Name ��r ('f) Project Location: County /VC/YY ulesattached.
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Address jqYO/W Street Address/ State Road/ Lot #(s)
City %If'/%(/�(fQNj State ZIP0411&
Phone # ( ) 13a E-Mail 6(4 A j.(�,4ubdivision
Authorized Agent. N f} City ZIP
Affected ❑ CW �w V4A ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
Agent or Ap licant Printed Name
Signature ** Please read compliance statement on back of permit
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Application Fee(s) WO I"Jy� Check #
Phone # River Basin i
Adj. Wtr. Body A n /man /unkn)
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jJ*l(k &(C' p
Permit Off er's P ' ted Name
Signature
_ /3 11
Issuing at Expiration Date

STATE OF NORTH CAROLINA, Department of Environmental Quality,
127 Cardinal Drive Extension, Wilmington, North Carolina 28405
Ph: [phone]
FILE ACCESS RECORD
DEQ SECTION: Division of Coastal Management REVIEW TIME & DATE: /
NAME: 1v nti REPRESEN/T�I,NG: �
EMAIL: N 1 V PHONE:
Guidelines for Access: The staff of Wilmington Regional Office is dedicated to making public records in our custody readily
available to the public for review and copying. We also have the responsibility to the public to safeguard these records and to carry
out our day-to-day program obligations. Please read carefully the following guidelines signing the form:
1. Due to the large public demand for file access, we request that you call at least a day in advance to schedule an
appointment to review the files. Appointments will be scheduled between 9:00am and 3:00pm. Viewing time ends
at 4:45pm. Anyone arriving without an appointment may view the files to the extent that time and staff
supervision is available.
2. You must specify files you want to review by facility name. The number of files that you may review at one time will
be limited to five.
3. CAMA Major Permits are issued out of the Morehead City District Office. The COMPLETE file is in the Morehead
Office and may contain additional infornWim and/or commeWs. which gay not be in the WIRO file.
4. You may make copies of a file when the copier is not in use by the staff and if time permits. Cost per copy is $.05
cents. Payment may be made by check, money order, or cash at the reception desk.
5. FILES MUST BE KEPT IN ORDER YOU FOUND THEM. Files may not be taken from the office. To remove,
alter, deface, mutilate, or destroy material in one of these files is a misdemeanor for which you can be fined up to
$500.00. No briefcases large totes etc. are permitted in the file review area.
ecessary large plan copies can be scheduled with Cameron. [e-mail] 919-796-7475 for a later date/time at
an offsite location at your expense. Large plan copies needed should be attached on top of the file. Allways Graphics
can be contacted to set up payment o tions. Written questions map lie Ieit tvifh this completed
oi"s' u provide your contact information where indicated ab``
7. In accordance with General Statue 25-3-512, a $25.00 processing fee will be charged and collected for checks on which
payment has been refused.
FACILITY NAME COUNTY
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3.
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4.
5.
COPIES MADE: PAID:
INVOICE.
GJADWShared/File Review Access Form rev 2018