54485D - Liles

.:-'ICAMA /7 DREDGE & FILL
GENERAL PERMIT Previous permit#
Flew ❑Modification []Complete Reissue ❑Partial Reissue Date previous permit issued
>rized by the State of North Carolina, Department of Environment and Natural Resources �j
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / " / '1G G G
! L�'Rules attached.
nt Name i L. 3
"7' 0#41c v C4 12d.
State,+! ZIP - ? $t
��)�'11�.t'%f Fax#( )
zed Agent (T (� P{ ,la �f' �✓
I ❑ CW i-EW B PTA n ES ❑ PTS
❑ OEA ❑ HHF ❑ IH UBA ❑ N/A
❑ PWS: ❑ FC:
yes A no PNA yes 45L3 Crit.Hab. yes / no
Project Location: County f74,1 1 '-- !C
Street Address/ State Road/ Lot #(s) 12 Ni
Subdivision
City,/ya L{Ypr /i G AC) ZIP 2 k Sy
Phone # ( ) River Basin L y,
Adj. Wtr. Bod"'�1 (naC
Closest Maj. Wtr. Body
,f Project/ Activity �� S?�Q i /y P'-� f LG a,�,, ;y ;'`: a �` �! �S'l � ,• c D , f'f L
)ck) length 1�Js' S �' —c / dui y , (Scale
_ .04
Bngth
ember
id/ Riprap length
g distance offshore
ax distance offshore
hannel
ibic yards
mp
ise/ Boatlift
i
ie Length — not sure
,s: not sure
'ium: n/a
Attached:
yes
yes
yes
yes
yes
4
no
no
no
no
no
-HAJ
ng permit may be required by:p`[%(�/✓ �P f ,J ❑ See note on back regarding River Basin ri
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ess of Property: s r-
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-ant:
Permit #:
ribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
i in your Habitat code sheet.
:at 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 final
disturbance.
Excludes any
restoration and/o
temp impact
amount)
/
Lv
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

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HOLDEN DOCK & BULKHEADS
GREGORY A & DOROTHY HOLDEN 3621
910-842-9732 HIS NCDL 4576438 HERS 5202642
1502 STONE CHIMNEY RD SW J/�y—�� ]� _ 66-1215/ SUPPLY, NC 28462 � =� 40
W WACCAMAW - ----- -
�= ,BANK
S.111y, NC 28462
urwru.wac bank.cn
F-27_X,5 -GPSN FSj 1312� _ .
nr
4053 L L 2 15 21:8000 L5?5301,6036
HeilanJ Ul-.
WILDLIFE PURTRAIT.S'N�