57343D - Henderson

'CAMA / _' DREDGE & FILL
'3ENERAL PERMIT
,New IModification ` :Complete Reissue Partial Reissue
Previous permit #
Date previous permit issued
-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 ,,1�l%U
f�lftles attached.
t Name —7eic �/c ; _, _ Project Location: County ?ea �c le
U Jjrs —�-s2d - Crl State C
O `f�ld/� _ Fax # (- -
ad Agent _re F .-
❑CW ❑EW PTA ES PTS
❑OEA ❑HHF _ IH UBA N/A
❑ PWS: ❑ FC:
Street Address/ State Road/ Lot #(s)12
Subdivision
City#d `cJoN ZIP 2 �y
Phone # () River Basin L�✓n� ,
Adj. Wtr. Body 0/y w (nat �n
yes t no PNA yes / no Crit.Hab. yes / no Closest Mal. "tr. Body
Project/ Activity �QPz7L/a C < '„- a �,� .� F e} /z 60,1
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( distance offshore
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g permit may be required by: �%d Ld G,✓ 6liRe
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❑ See note on back regarding River Basin rul

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1�1:02 From:
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�IOt�1:�1f18 Cig19t►t di ��� a� ��Oc�fC6s
MOSM F< Eaft. wr Omsk" of ca"m "ImmPowlit
Jow IL amoson, tlkwoo �
AConseft A+�tt
is herd zed to Pct
in ordw to a'Mob ow CAM^ pangs) nMuwad fm tft pmpehy NOW Wow, The
SPecift aCdvffim dettrbme' in the aim s1ce1c#►_
LMATIM 4F PROJECT:
/2s SC�c�a�h-e-��t
7T�
.v 32Yla07
�ekYl.S

)plicant: e C!PiLso�
ate: ' eel:
Permit #: 2-3 5"3 —'�)
!scribe below the HABITAT disturbances for the application. All values should match the name, and units of measureme
and in your Habitat code sheet.
bitat Name
L
DISTURB TYPE
Choose One
Dredge ❑ Fill � Both ❑ Other ❑
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
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)
e S
FINAL Feet
(Anticipated fii
disturbance.
Excludes any
restoration an(
temp impact
amount)
C
y
Dredge ❑ Fill ❑ Both ❑ Other
� 5 Q
75 d
(/V
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 ❑ Both ❑ Other ❑
Dredge 0 Fill 0 Both ❑ Other ❑

HOLDEN DOCK & BULKHEADS 4028
GREGORY A & DOROTHY HOLDEN
910-842-9732 HIS NCDL 4576438 HERS 5202642 66-1215,531
1502 STONE CHIMNEY RD SW �j �i l 840
SUPPLY, NC 28/462
W WA$ANK AMAW
�yNC 28462
www.waccamaw nk.c
• For � Pi S�In �,�11''"i�7�i'�-' _..._ /�,�
1:05311 215 21:800015753011'011034
neilantl cl—r WILDLIFE PORTRAITS®