61673D - Jackson

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CAMA / C DREDGE & FILL r
GEWERAL PERMIT Previous permit#
New Modification ❑Complete Reissue '—Partial Reissue Date previous permit issued
>rized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
it Name ,-1 -Cx A t Project Location: County
A v1 ttG K d et R tX-' Street Add ress/ State Road/ Lot #(s)
N� Y� State ZIP z�i3-+{ 1 L.. �1 �C ✓-f 15
( _Fax # ( Subdivi ion f}�
zed agent U i C1�M5 �U-- Ci (L, i ct, ZIP ��
i ❑ CW JJEW U PTA ❑ ES _! PTS P c� ¢ q 1 ,
/` hole # (IIG ).�io (oSlo River Basin W(Y1
El OEA ❑ PWS: ❑ HHF ❑ IH El FC: ❑ UBA N/A
Adj. Wtr. Body OJ (natC yes ;/ no PNA yes ,/ noT Crit.Hab. yes f no Closest Maj. Wtr. Body AlW0
if Project/ Activity I u bv0111 Gi V ► T- {: k i t i , ;'het- U n
. v , (, 10 S�rc.rW kKAAtom' C.� (Scale: ) //
Eck) len h_
n(s) X 2
pier(s)
ength
ember
ad/ Riprap length
(g distance offshore_
iax distance offshore
:hannel
ibic yards
mp 42 Of
use/ Boatlift X
5A4�-L4--"-XJ-U
ozing
ne Length
not sure yes
gs: not sure yes
,rium: l ) yes .
Attached: yes
ling permit may be re

Qav�nQ
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i Q: H2 From
KKhW Fz Eby, Ga%e
To:8429M6
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WM Camfi1e DeW Qi ant aW Natural Pmou:m
Okk*m of Comm lion�
:#arras tL Q�egiosi. Okwor
Au!ltoritev Age4t Consent 11+greenWetrt
is hereby au#xwimd to act
in orft to obtain any CAMA panam*Oj raq-L*ed for flue property wed below, The aulhorinWn
specific ae gis detCM ad in the attwhad Mmict►_
taDCATtOK OF PROJECT:
"c L-�s D V, q
PHONE M -

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HOLD E &BULKHEADS
GREGOR OROTHY HOLDEN . 203 5089
HIS NCDL 4 HFRS NCDL 5202642
M9732 OW
1502 d1�IMNEY RD.
S NC-
e C
� PAY TO THE
ORDER OF
DOLLARS
IN v�
�44i First ,
COmmui/ Bank
Z FIM RRrc«
MEM _ ZN //we- d— 3f41tc..rr rrr
1:0 5 l 50 l 2 9 91: B000 l 5 7 5 3011' 9
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address 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?ea1' *?-1Y
C �� � r��► u�l .�'. C
A. S' ature
by (
C. Datd of
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2
7011 0110 0000 8671 5158
■ Complete items 1, 2, and 3. Also complete A. Signature
item 4 if Restricted Delivery is desired. X ����❑ Agent
■ Print your name and address on the reversed ❑ Addressee
so that we can return the card to you. B. Received by (Printed Name) C. Date of Delivery
■ Attach this card to the back of the mailpiece, v S S EL L /a / �4k
or on the front if space permits.
1. Article Adrlrassarl tn•
D. Is delivery address different from Rem i2(
_ -

IC Division of Coastal Mgt. Habitat Impact Computer Sheet
pplicant:
ate:
Permit u I�'I1t�50
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
)und in your Habitat code sheet.
abitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
(l 1
V 1
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 ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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