61526D - Wells

-ICAMA / ❑ DREDGE & FILL N �' 61
GENERAL PERMIT V Previous permit # (7 Z3
]New VHodification ❑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 7 _ i i. r), j I JIB . I Aw
l WRules attached.
it Name [N} l JP! M-1 L''s Project Location: County
iy
1y _1-t'1 &T State NcZIP isW
Street Address/ State Road/ Lot #(s)
17 u;� 7 S
Subdivision
zed Agent City A, i (" jc �f N T ZIP 7 ��
i ❑ cww PTA Es _ PTs Phone # ( ) River Basin
OEA ❑ HHF _ IH _ UBA ❑ N/A Adj. Wtr. Body f�fx .bat
❑ PWS: ❑FC:
yes / no PNA es / no Crit.Hab. yes / no Closest Maj. Wtr. Body r1-
f Project/ Activity a, t4 i(� Y)
T ;� r!'� ����� I I k� ► i\1 o (Scale: /f=
)ck) length
:ngth
Jmber
id/ Riprap length
,g distance offshore
ax distance offshore
:hannel
Jbic yards__
mp X
use/ Boatlift
3ulldozing
ie Length
L
not sure yes L� 'q ._
gs: not sure yes )'
rium: n/a yes io
e3 no
Attached: yes 6P,
ling permit may be required by: C) . ❑ See note on back regarding River Basin
i /-I- - i� /11'.. 111 1 J � �.. -"7 J 1 ! J . i i / ...t-v i - r