56553D - Green

CAMA / - DREDGE & FILL r1
GENERAL PERMIT Previous permit#
New ' ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources 'j
oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
[$Rules attached.
Name ;��, o ^r ' e P� Project Location: County 307N'VS4✓1c'e
y 3 6 S S ✓ d . Street Address/ State Road/ Lot #(s) / 19
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State,'/C ZIP -22 S _
Fax #O
AAgent r!Z P6 Q/u.✓
❑ CW
❑ OEA
❑ PWS:
yes / no
❑ EW ❑ PTA ❑ ES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ FC:
PNA yes /-G) Crit.Hab. yes / no
Subdivision
City//01010-11 e-04c- i ZIP 1�
Phone # ( ) River Basin "�
Adj. Wtr. Body 0944L �'�� .14i411w (natQ
Closest Maj. Wtr. Body '-191 h'1A" 1
f Project/ Activity r 2"O! 9C �P
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ing permit maybe required by:
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❑ See note on back regarding River Basin r

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AMOKMEMIA
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Noah Gaatne D%w ma gof Bwimn nm aid Natural Pumurces
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&dhorbwd Agent Cordw tt Agrm €t
4 ^It}{gtll G
is hweby M*wtnd to act (
in order to obtain any C.AMA patniks) rsik- ed for tha property fisted below, The authorization h
specific actiritiee described in the attached sketch -
LOCATION OF PROJECT:
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AUTMORMED AaEH'i MAIUNG ADDRESS:
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PHONE MQ326 01" L
PHOME NO, 4?/D 7f f- 9 -117 J

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Wftffhmh)uSWC 2Uffi mr �3i S-
tia iG days of aftwu no.rexponstss eausidered the =meas um obi
baft bemuVffftd byCe4fied.
VWMgm, brealuffatw, board house or bait aft m
�kaa� �I� finest a�area of - _ unless waived by D
wihto w2betie =Wbsm&,youuae€bNait
approp
below
i domishtowaheThe IN scd)wkreqmmwxmL
I vishiO waive the IY setback r ent
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Permit #: ) � C—SJ 3
tribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
id in your Habitat code sheet.
itat Name
DISTURB TYPE
Choose One
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)
FINAL Feet
(Anticipated fina
disturbance.
Excludes any
restoration and/(
temp impact
amount)
SL
Dredge ❑ Fill —Both ❑ Other ❑
SQ
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 ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

HOLDEN DOCK & BULKHEADS
GREGORY A & DOROHERS 5202642
7HY HOLDEN
910-8';2-9732 HIS NCDL 4576438
A502 STONE 21,462 Y RD SW
SUPPLY, NC 28462 IJ
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a
3787
66-12151531
S40
1���3"ems
$ Ioo
f.4W..
a oaww"
kV
2�
Suj,28462 ��✓�� ( J _
nn,nu.uwi,:camal"luiuk. COO
for
Tr 5 5 3Ou■O W o FEP�A,AA
p 5 3 1 1 2 Is 21:800
'.1-1 Clarke