67980D - Williams

'`LAMA DREDGE & FILL
7 RA 0
"MIENERAL RMIT Previous permit #f) U I 10
i New -Modification Complete Reissue []Partial Reissue Date previous permit issued
-ized by the State of North 7arolina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC (y)
t Name N I ( I, t, �e / Project Location: County L" Ell �Ies attached.
T i.l S S Street Address/ State Road/ Lot #(s)
I St'at I e t4.-,Zlp 3 1 '1 14 G+ -
,UZ-3 7-7 —ZV -Mail Subdivision
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ZIP
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0 OFA 0 HHF 0 1H 0 UBA 0 N/A Adj. Wtr. Body h 1 vvh4 (Tn—atYr
El PWS: Closest Maj. Wtr. Body low
yes /(`no�') PNA yes /(no—)
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g permit may be required by: V -ev (,4,k ❑ See note on back regarding River Basin r
ocal Planning jurisdiction) I

-- ICAMA /' DREDGE FILL N? 67109 A B C
GENERAL PERMIT Previous permit #_
ONew Modification DiComptete Reissue DPartial Reissue Date previous permit issued
xized by the State of North Carolina. Department of Environment and Natural Resources f2
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
nt Name #1 /e-ALi e- 411 "I iiyI Project Location: County! (Q Tez
, } _36f _-..__111:.l L l7_ _ _._ __L _ -- -__--- Street Address/ State Road/Loot #(s)—
i�J_ --- Stat�'ZIPG' --- — q �_{ -
4t (AF4-) _ 22f> —4y -Mail Subdivisl --
zed Agent _1�' - --- _ — City_ __=—�-- - Z►P 2�
i i-1 CW � )tVTA r ES 0 PTS Phone # (""'�'—'—� — River Basin
OEA F C tM 0 USA '�j WA
Adj. Wtr. Body- �/ Z At)
Pws: Closest 7�G
PHA yes � osest Maj. Wtr Bodyf
Yf Pro«v Acti q
I
%tlorrn(s)!'t -- 3 ,� ia, ,f,
Palferm(s) ._--_--
s) �
umber
wV RiprV
tax dannce _
twInal
ibic yards _ &OASTAL
wnp
not sure yes t
irium Wa yes _.. _ -_--_ _ _ _. _ + ,
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Attached: yes j ndj -FAGM G`D.'►'1 t 41 WI "--i>
ling permit may be required by: P
t Local Planning Jurisdiction)
I Special Conditions
(State:
f7' _ 31cewrck*
_ 4,114%L,
See note on back regarding River Basin rubs.

ayment Proccessing Confirmation
late Received 12/19/2016
heck From (Name) Brandon Grimes (Money Order)
lame of Permit Holder Michael Williams
/endor Western Union M.O.
;heck Number 17-491423331
;heck amount $200.00
Aultiple Permits No
Aajor/Minor
'ermit Number/Comments GP 67980D
teceipt or Refund/Reallocated JD/ 3D