59237D - Morris

TCAMA / E;OREDGE & FILL
F 'A
3ENERAL PERMIT Previous permit #
�ew EModification El Complete Reissue E]Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources -74,iioc
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
F-7Rules attached.
t Name CAAA�O M Rpl S Project Location: County be"UNSkN I
StateNb zip 1311
Fax # (
:ed Agent
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Street Address/ State Road/ Lot #(s)
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Subdivision
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Phone# (—)
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River Basin &Uf V I �
EIOEA HHF EAH UBA F] N/A Adj. Wtr. Body 14')ww
0 PWS: El FC: I I
yes /0 PNA yes/ (�' Crit.Hab. yes no Closest Maj. Wtr. Body
f Project/ Activity �k
(Scale:
Ock) length
-ngth
imber
W Riprap length
g distance offshore MRSK
ax distance offshon MENEW.MaRl.
hannel
MAW=
ibic yards 0 N
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use/ Boatlift "HOW." rla I�FAVJ
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lulldozing
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ling permit may be required by: A -it �-'14NO El See note on back regarding River Basin i
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&AW1
NWENR
North Carolina Departawt of Environment and Natural Resoumes
Qivision of Coastal Management of Frftman, Sevetay
B&AWy Ewa Perdue, GOMM damns H. 4roWn, Director
Date --
Name of Property Owner Applying for Permit:
�ft if � ��•�I
NUftg Address:
7/ { e.• S
4 c.
X certify, that i have authorised (agent) '" • ' a; f to act on my
behalf, for the parpaec of applying for sand obtaining all CAM Permit* awry to
instail or coastr uet (activity)
at (ray property kmmftd at) y� yye Lz4,
Tina certifi ation is valid tbrn (dale) �U .
Date
Property Owner Signatare
y

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pplicant: C mogg IS c
Permit #:
ate: CC( L J`l
51241(Z U
!scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
Lind in your Habitat code sheet.
bitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
Dredge ❑ Fill Q/Both ❑ Other ❑ I I'�U
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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/o
temp impact
amount)
0
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 0
Both ❑
Other 171

■ 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:
j6AP\V11 rs �G
%20219jplie
t ng fw% A/
2g 110 3
A. Sianatdm
%ivect- fprin Nam
D. Is delivery address different
If YES, enter delivery addre
Vntressee
elivery
item 1? ❑ Yes
?low: ❑ No
o. aervlce type
'IR2ertified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. nestncted Delivery? (Extra Fee)
2. Article Number ❑Yes
(Transfer from se- 7010 3090 0003 7163 6662
PS Form 3811, February 2004 Domestic Return Receipt
102595-02-M-1540
■ 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:
Of (cAn, e Dool -e �
(ZD-� lqjr l e tt2cf
(n 11 ht A 1 fah NL.
Z81-10 3
A. Sig re
❑ Agent
X ❑ Addressee
B. eirv/e- y (M to ame) C. Date of Delivery
UL^�i� - S i $ 1'
D. Is delivery address differen 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.
9 Articles hh—f—
4. Restricted Delivery? (Extra Fee) ❑ Yes

■ 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:
/411� 491^14�ff
f L L FG 1-/5 ST
Z83�y
3NI� 03ll00 ltl O
1H'Jitl 3N1013d0
A. Sign re
X YA A'g Agent
Addressee
eceiv
,2 b (P 'nted a'm C. Date of Delivery
D. Is delivery address different from item 1? El Yes
If YES, enter delivery address below: ❑ No
3. e vice Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article r7010 3090 0003 7163 6693
(TransferrNumber
fromom service labe
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
■ 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. Signature
An� ❑ Agent
❑ Addressee
B, eceiv/e�d �y (P/rijnt a e)��j C. Date of Delivery
�,.,,7 ' rintr, '{
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. Article Number 7010 3090 0003 7163 6686
(Transfer from service label)