38962D - Holt

;LAMA / n DREDGE & FILL
i,.
iENERAL PERMIT Previous permit # va
14ew -Modification JComplete Reissue El Partial Reissue Date previous permit issued P,r
zed by the State of North Carolina, Department of Environment and Natural Resources 7 ZD O
>astal Resources Commission iin, an area of environmental concern pursuant to 15A NCAC EJ Rul attacheo.
Name l �''� Project Location: County _r 0
C7'Z
y i_- Statd v L ZIP -Z
911 S Fax # ( ) /
;d Agent f t^ I 1 '� t% 1 4fj
❑ CW
❑ OEA
❑ PWS:
des /lam'
T"�EyV X"A ❑ ES ❑ PTS
❑ HHF / ❑ IH ❑ USA ❑ N/A
❑ FQ
PNA yes Crit. Hab. yes / n0
Street Address/ State Road/ Lot #(s)
Subdivision
City t/ /I, ZIP ZW N y,
Phone # O River Basin
Adj. Wtr. Body
Closest Maj. Wtr. Body �T �� Oe
{ S'
Project/ Activity (/h Sy/UG ��
(Scale: / �1-
:k) length
i(s)
ier(s)
ngth
mber
d/ Riprap length_
g distance offshore_
ix distance offshore
hannel

I
m
WK
nN �r,-r.
_: d-Oo

AMM O ,E = P O ` -,TZWVM
r he-reby Gat* Brat Y awn perry 4aoent to.u. Je.S -J -.HD [ t
(Name of Pruverfv 6ti ri
property Iooatcd at - 1 1 \ 3 q"-" 1, SO+ f
(Watetbod )Vt
A.pplimaVsphone#-, �� 1 3�1'���g�a �. �Cl�`no(e.t C,aYCSfYUG�w✓�
IQS
&Ktadf �r J__fC
He has describod to m—ei 4 ahown below. tht d t he -Proposing at that
have no. Wins to W pxapo&W I understodAm a pWftuorh�g pilings / bo Wife / boatbouse
must be set back a minim =- xuot4uuoof fib *4 Ml- ftm try Amcf.ripacian wfess gees
Islet tc� wAve tia setbsg uert:
Mm
' erndt)

Ihereby eort* fil atI own property adjacettc.to.�.� I_ _ H o lT s
{Name of Pruperty 6w er)
Pro, imaw at 2.u..3 `t f'" sf ,
(` CAJI�1 rti.Q S mm W
(WattA61W MWA
lids heue #,-! 'fin o Covisf�w �sr
He has dwribed to njej as shown blow, the daft1opnMt he is proposing at that l®catiEn► am, I
have no*mtions to lzxs proposal. I uftderstmid timi:e t � g ! I atiift / boathouse
must beset b k mmi ntun d#woe. of i t t l �j #fit m-my area Of ripadup acmes unkss
WOmed by:mm -OrrwIsuh to Ihe_"t%GkI-Y' .*_"tAAW%►PftF e.bhAk
I Itof I to waive
-. A i ft wi* to waive Mat_ get Tnutoit#i>X.
+✓rRM.� 4 tA?R�. v" " m or MPOM
:tbr 1e'ermtit)
P
Awlfits
�_ . � P" per hd+ fian)

Mlftdf. Eo*y_.Ggvwor
North Carorma DePwhent Of ErArOnamerd and NaturA resources
Division dOo��O Nampmgnt
cbArtal-S., Jones, Diftdor
Atft.efl.Zed Agent Consent Agreoment
willifemG.Am Jr.,
-n
to hereby authorized to -act on my beW'
imler to obtain aqy CAMA perntfs) ro-qubW for the prey JkWd bakw.. 'die authorization t$. RMI%d to the
ecftacbviff" dosgribed, in the aWW sketchi
)CATfUN OF PROJISCT4.
tOPERW OWNER MAILING ADDRESS:
PC) >( :51
au
ITKORIUD AAtWt NWL1146 A06RVI&
ILI
IJ
PHONE Noq—. to .3�a 3
Mature of Propedy Owftv-

plicant: J ��
te: 71(6�/ 2—
Permit #: 3�' 96 z
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ind in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft,
TOTAL Feet
I FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
)itat Name
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts)
amount)
k
Dredge ❑ Fill ❑ Both ❑ Other
/ 6 5
Dredge ❑ Fill ❑ Both ❑ Other ❑
—� ■ 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 1. Article Addressed to:
�vtiMovu� �rFt�
�Ust i�d nr� a�i�
A. Signature
❑ Agent
❑ Addressee
B. Received by (Printed Name) C. Date of Delivery
D. Is delivery addr?ss different from item 11 ❑ Yes
If YES, enter delivery address below: ❑ No
3. SeKce Type
U Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Pansfer from servic 7011 1570 0000 3560 7539
PS Form 3811, February 2004 Domestic Return Receipt
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
102595-02-M-1540