60775D - Lamb

'CAMAS -DREDGE & FILL
No. 60
'ENERAL PERMIT
f// Previous permit# 'c—
"ew ❑Modification ❑Complete Reissue CPartial Reissue
Date previous permit issued — r
•ized by the State of North Carolina, Department of Environment and
Natural Resources
;oastal Resources Commission in an area of environmental concern pursuant
to 15A NCAC
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❑ Rul attached.
t Name It,..
Project Location: County
1 % V`'
#-(s)
Street Address/ State Road/ LLot.rl��
- 0e Stated, ZIP
�
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?—/0—)"Irt7s' Fax # O
Subdivision
ed Agent!'1�t''/ G
City ZIP !fir
CW _aLy PTA DES ❑ PTS
Phone # ( ) River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body ! "�' =� naE
❑ PWS: El FC:
es no` PNA es no Crit.Hab. es /
Closest Maj. Wtr. Body �t"L
' Project/ Activity
ck)length
f 4r/!
(Scale: A f7

)licant: 1/1/ G� ✓ [/- �i� li�Lc,. Permit #:
:e: !z _ C/--
cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
id in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
itat Name
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
f%
■ 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:
r-q yitS '9(a n I UC,
Jq ,W OWAN�Mk ed
&c,r,vi kL a-15u 1
A. Signatyre
X C ❑ Agent Q
co dQeps
B. Recei by ( Printed Name) rnt %f;dVe
4-4 A' 0;/11<
D. I delivery address different from ite
If YES, enter delivery address below:
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7005 0390 0001 5619 0642 +
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-15 0
■ 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:
A. Signatur
Z'�� ❑ Agent
❑ Addressee
B. d by (Prince Name) C. Date of Delivery
7-1 <_ 6fl' 11 / / - zl -r.
D. Is deliver/Adress different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
Island Zv . ItI LI-C,