57333D - O'Donnell

-,CAMA/ !DREDGE &FILL
SENERAL PERMIT
�lew ­%. Modification ❑Complete Reissue Ll Partial Reissue
by the State of North Carolina, Department of Environment and Natural Resources
il Resources Commission in an area of environmental concern pursuant to 15A NCAC
Name , -1--f- 111 � :1. a
Agent
Previous permit #
Date previous permit issued
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FTRules attached.
Project Location: County A& tt,,
Street Address/ State Road/ Lot #(s)
e"I-ee"e zel'.V"
Subdivision
City— W/ , 4F
ZIP
!d " Cw iEW PTA ES PTS Phone# River Basin
E OEA HHF L1 IH EI UBA El N/A• Adj. Wtr. Body (.-K--e- 14 na
E PWS: El FC: Closest Maj. Wtr. Body
�_s no PNA (g) no Crit.Hab. yes / no
of Project/ Activity
state 4?' zip_-ZOL/'/
Fax #
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ling permit may be required by: 7,0-7f // ;;0 4��
,og See note on back regarding '11ww_ Basin
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--e ^ •- rc � • i / VfV f
NOT WK-AILLONP AIVER FORM
ss 0 Piq aj,_ I- sx?
meet #, Street OF' R m
di
},
by
b y �.�_ Sys sub c s orw? propj v e--a �a� x�ced property- Tileiu.&v�dil34
ingfor ihispermi-Lhass desmabt ne me as sho%m s, fue aftcheddradng the development the;
Dposm& A eles Lion a wilh , shOnid be provided mifiifiiis ez." .
ez, N� d'i3✓ Ec Tt �J /r' 7113- W44r-:- 45 41WV t-2� �O No IVA6!�_ 77-f�9n1 i3lzr .,- 13 F
Ti 6'- E tv,r r�q rftE T71EQ' 43 r R46,--6
• ��' QbjecaG= t4 VeR2 13 being $ r�cay os , q le2sa vir—na the km? sio of
Cori.
� ['� T�(sp _' _ �3•,•a q�y� yr, cr+� �� -�s z (fin
r-' 1 4-J� 'y s 'c di � � y w '3�.41- �Na4111�1 .M3�L ,,;; 2 li r^ .�f.. .ram L.-L'� "Y�Vat�WR i}.. ulG�LiliJ{i�i GYa�J 2%
$byGeedW
a
the "' ; YeR mime- P>� the aPpmard m b L4&�
1 do wLqh to vmive the 151 re9! ffit.
1 e.-n ztot w to waive the iY sed�ck A cq uhzmei-ut
ASO

All MUN
ADjACa'a—I R A'RLA—N PROPERTY NOTEFICATION/WAIVER FORM
of Indi-,,-dual Applying For Permit /�i` (J �®did%Gr'�_ —
ess Off Property re
(Lot or Stred Street of Road)
mity 2
g_-by cer�r that I ovin property adj'accut to the above-refameed PrOPertY. The in(fividual
,rmg for thus permit has descrfred to me as shown on t.he atta&ed cisawing the develop —a imt floe Jr
--4 - shod -1 this
mposin& A descr.p6on or dra, incr vAg, shou d be provided Vatl
I hwn no objeclicps to tis :P�t OML
�m hZ70 tm what !S Iming propa*A please We the D Of
zgemem4 127 C,-u-dbm- 1 Drive Exwmdon,, Wgmhtgton,, C. 28405 or calif 910-195-39061
im 10 d2YS of r.�Cejpt o$ th"."s m-- tim No res- Pm=- 41S aGusideread the same- as 3u, o Objicfiom if
hgve beeR
uix-
3J.6tt! TEL m':r
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'-Gef, Us jr bu Hft I& N-
th2t RIG
ana a
01 om awed LV me- (11
-r-myjarea wi -up-2mccess- messw Y f
wish to waive the sethack,. you M-mt miff- the .211PPIMP.—I-112te 1&.711- be'IBOrTiv.)
i do wish to waive the 15' sedgy
I do not ri to WMW the 15" sedrank --
Date

Division of Coastal Mgt. Habitat Impact Computer Sheet
)ficant: f ja� %Dy��� (� Permit #
le:
>cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd 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/o
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts)
amount)
t/ v
Dredge ❑ Fill ❑ Both ❑ Other
I ?-"3
-2- 3
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print you[ 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:
- rnR. ("t -6. "ate
I
MLIM Cast aJc
t I rn., nc a% 44s�
L1
Printed Narp6j/ I C.
❑ Agent
B Addressee
D. Is delivery address different from Item 1? E) Yes
If YES, enter delivery address below: ❑ No
a
3. Service Type
JRCertified Mail ❑ Express Mail
❑ Registered ❑ Retum Receipt for Merchandise
❑ Insured Mall ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
- 2. Article Number
(Transfer from service label) 7010 0290 0003 0833 8567
PS Form 3811, February 2004 Domestic Return Receipt
Dredge ❑ Fill
Dredge ❑
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Dredge ❑ u-r1
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Dredge ❑ M
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