61584D - Edwards

A, -AMA / rDREDGE & FILL n lrU 611
37tNERAL PERMIT Previous permit # (,, 07
]New JModification Complete Reissue ]Partial Reissue Date previous permit issued j _ I
rized by the State of North Carolina, Department of Environment and Natural Resources I
-oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Rul attached.
t Name P-�i y! ✓eAJ C- } °f f ��' 'rj s Project Location: County �t4
to 7 .r F . A ) JM), 5 0/ ITT /;,ap Street Address/ State Road/ Lot #(s)
State CA ZIP yzko s , 10 i-- LAE GL mik
Fax # ( ) Subdivision
;ed Agent f//) ('_ / City e1/ S uc..P ZIP
❑ CW �W Ci PTA L ES ❑ PTS Phone # (' ! 0)3Z /a /River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body -1W (nat
11 PWS: ❑ FC:
yes / Brio PNA yes / n® Crit.Hab. yes / Closest Maj. Wtr. Body
' Project/ Activity /
l4ua
ck) length
ngth
tuber
prap length Al
distance offshore
uc distance offshore
cannel
)ic yards
rip
se/ Boatlift
ulldozing
e Length
not sure yes no —
s: not sure yes
ium: n/a yes
yes
4ttached: yes
ng permit may be required by: V"Y%':;/-y IVA ji -- . ❑ See note on back regarding River Basin r

icant:
e5 — � — �3
MMM
-Jibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
i in your Habitat code sheet.
3t Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.FDisturbance
(Anticipated finalied
disturbance.
Excludes anyncludes
restoration
and/or temp
impact amount)
L Feet
for.
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge❑ Fill❑ Both El Other
`Z-0
26
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑ Both ❑ Other ❑
Dredge 0
Fill ❑ Both ❑ Other ❑

Bank of Amerlca
ACH R/T 053000196
ID LEE BUILDERS, INC
O BOX 3156 [phone]
OPSAIL BEACH, NC 28445
19010
66.19/530 NC
21429
$
--- �� DOLLARS