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Home My WebLink About60782D - Leland. &MA / ❑ DREDGE & FILL IENERAL PERMIT New ❑Modification ❑Complete Reissue ❑Partial Reissue No. 607 Previous permit # Date previous permit issued zed by the State of North Carolina, Department of Environment and Natural Resources 7 :)astal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7 lt7Rules attached. Name / ( j ( i� �_/ jfi1! - N ��- `�"x C �: Project Location: County 14 Nsm Cx- �^ c J'my ffm-C !> 1. Street Address/ State Road/ Lot #(s) 1✓. State NC ZIP z 015"/ j L/ 6 Fax # ( ) Subdivision �dAgbnt ! l 'tJT t**- i' 1.N�1i+lie7!'tl1/�� P ?� City Lt 2 ItNA2 ZIP_ I CW EW 0PTA ES [.l PTS C OEA HHF IH C UBA N/A PWS: 7— FC: Phone # ( ) River Basin el Adj. Wtr. Body !n i e (- E )2A,I Ciet�LX e%ln C� ,es / f PNA yes / no Crit.Hab. yes / no Closest Mal. Wtr. Body Project/ Activity 8/ - 16 8.r 1: , r"e— MAO• NO MAKAU distance offshore V i distance offshore Elliff i3wTa—mm— ME NO FV :ri MMMMIM ��ii i■ ■■"�i i VIMe� ii�iii�iii�_i■ not sure yes � n� not sure yes � gym: n/a yes �7 yes nO2 [lathed: yes ,Oti� g permit may be required by: L F_ L HIV► ❑ See note on back regarding River Basin ru evenly Eaves Perdue governor NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Braxton C. Davis Director AGENT AUTHORIZATION FORM Date: 11-8-1 me of Property Owner Applying for Permit: town of Leland ner's Mailing Address: 12 Town Hall Drive :land, NC 28451 one Number 910 371-0148 Dee Freem, Secreta Name of Authorized Agent for this project: Right Angle Engineering Agent's Mailing Address: 212 Princess Street _Wilmington, NC 28401 Phone Number( 910 ) 251-8544 �rtify that I have authorized the agent listed above to act on my behalf, for the purpose of applying and obtaining all CAMA Permits necessary to install or construct the following (activity): my property located at _844 Appleton Way, Leland, NC 28451 certification is valid thru (date) _11-8-13_ II/sr/!'A Property Owner Signature Date . I I r>� m(Domestic ra For delivery information visit our website at www.usps.com., Q- W. L5 0402 U-) Postage $ Certified Fee # • q5 12 M O Return Receipt Receipt Fee (Endorsement Required) �� Here 177 t3 Restricted Delivery Fee (Endorsement Required) O O Total Postage & Fees $ °i 271201 ru Sent To a 0 fti Street, Apt No; ^ / L.- or PO Box 'W No. ' 2 H4- o `J— ---------------•- I" --------- ;� See, P+4 (3" dA PS Form :rr August 2006 See Reverse tor Instructions ! i 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 C to -1v%ve-skw-x Pro rkeS Q02 A. Si at PK X ❑ Agent Addres B. Received by (Prfnted Name) CC Daher of elit D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 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 FINAL Feet (Applied for. (Anticipated final (Applied for. (Anticipated final bitat 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) -�� Dredge ❑ Fill ❑ Both ❑ Other e Z-7 S t75 E16 Dredge ❑ Fill ❑ Both ❑ Other [� I1 lTI q-(a Dredge ❑ Fill ❑ Both El Other Dredge ElFill ❑ 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 ❑ lk. Town of Leland 102 Town Hall Drive Leland, NC 28451 OCT 3 0 2012 1141NGTON, I NCDENR 1601 MAIL SERVICE CENTER RALEIGH, NC 27699-1601 - - -- - - VENDOR NAME VENDOR NUMBER CHECK DATE CHECK NUMBER ----- ------------ - - — - NCDENR 269510/23/2012 26214_--__ DICE NUMBER DATE PO NUMBER DESCRIPTION AMOUNT 12 10/2C/2012 STURGEON CREEK 2_00. 15-810-1000 Remittance total 200. ■ 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 hack of the mailpiece, or on the front if space permits. A. Signatuf� X,� Agent Off" — � �' - 'r' p Addressee B. eceived by (Printed Name) C. Date f Delivery Ct'-&-1 � W a h-e (( - V -/Z 1. Article Addressed to: D. Is delivery address different from item 1? ❑ Yes