54560D - Perkins

541
CAMA / " DREDGE & FILL
jENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ized b� 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 A Rules JaI ched.
Name 1
Pro ect Location: Coun401 Al ty"' T�li✓Y!'
�l �"G � �` � �
1 / rpPt,of ;/ , Street Address/ State Road/ Lot #(s)
f �4011 j lr +�t I t f °btate_Ite ZIP SI'lrL• t t'
t*) 6Fax # Subdivision
ed Agent �[�"Vli'hy} r� f/S �'"; City ZIP ti
❑ CW E!�& .PTA ❑ ES ❑ PTS Phone # ( ) --914-oy River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body 5 ��� na r
❑ PWS: ❑ FC:
yes 11-68) PNA yes / Crit.Hab. yes / no
r
Project/ Activity
ck) length
iier(s)
!ngth
tuber
d/ Riprap length
g distance offshore
ax distance offshore
hannel �9 %
ibic yards
mp
use/ Boatlift
sr^
3ulldozing
+r
ne Length _
not sure yes /io j
Closest Maj. Wtr. Body
gs: not sure yes /nof
)rium: n/a no
yes oo f
Attached: r yes V
Ping permit may be required by: ►V �'/
A 1✓ )
(Scale: / 0
❑ See note on back regarding River Basin i

Coastal Earthworks, Inc.
1955 Middle Sound Loop Road • Wilmington, NC 28405 • Phone: [phone] • Fax: (910) 686
&eo r y Per
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2010 15:45 FROM: T0:6867555 P.1/,.
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Coatat'Earthworks Inc
iw MCOLF SOUND LOCW ROAD PKcmE 49-to) OW7565
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Fp,OM-. TOM FAX# �(910)686-
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PLEASE CALL IF AMY PROW -EMS OR ERRORS WWH REC'eWlNG
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JUL-23-200'9 06: 21A FR01: F8S t1AI2IhE 910xw6.1262
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NCDENR
North Carolina ctpar`.menl of Environment and Natural Resoumea
Divitalon of coaatai Managtmtnt
Waal F Esalty, Governor Charles $. Janes. W600r W�iiarn G. Ross Jr, Slatral
Authorized Agent Consent Agreement
(��,(, J(!� r' ✓`�_ _"+C� A h r �i ri­ri }n orj nn m­Doe
h�if
in order to obtain any CAMA permits) required for the properly listed below The authorization is hmi ed -It—
specltic pcilvIties dascribad in the attachad sketch
LOCATION OF PROJECT:
a 1 1�>• L-Ur►+�M
A)AamoWN 1%a) W a 5
-�] PROPRTf OWN RMAlLING At�DRESS:
�oeG� �,ek��-x 3D E4
LA 4,v i'1e_Lv_1C1_
..6�R12b 2 7 3 n
AUTHORIZED AGENT MAILING ADDRESS;
WW
77
J q .... 14
Signature of Property Owner.
Stpnstum of AuthorfYed Agent
Date,
PHONE No. l.. 2 — %14 75 6
PHONE NO.
127 Card nW Qrin Fa l , Mmr.94on, NWW4 Carotin 26405'%W ru.net
Phone. 910.MT215 t FAX 910 ]95-3%4 t lnromer +rww nrxotslelrr.nt(�rrto
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°C Division of Coastal PAgIt, Habitat Impact Computer Sheet
>plicgnt: i�✓ '''S Permit #:
y
tte:
:scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
abitat 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/c
temp impact
amount)
6
Dredge Fill ❑ Both ❑ Other ❑
gg I
914sl
Dredge ❑ Fill 16Both ❑ Other ❑
leo
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 ❑

COASTAL EARTH WORKS INC.
010) 686-7555
1955 MIDDLE SOUND LOOP ROAD
WILMINGTON, NC 28411
Date
Pay to the (1
Order of,
C-A
COOPERATIVE
BANK
W ILMING'rON, NC
For_1erNn[`'T'"�,PS►-i�(oc)
1: 2 5 3 1 7 1 7 28i: 16900 10 30 2
3714
66-7172/2531
�" cb 00

■ Complete items 1, 2, and 3. Also complete
a , Mm 4 if Restricted Delivery is desired.
Ir '. i-int your name and address on the reverse
so that we can return the qard to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
'V-cd- F,J+e r p N s e LI C
f 11 C.Sti-e Ad y,J-f PA .
QI fn4J3A_f�__� 101 C. 2 9 f o
A. Signature
X ❑ Agent
----� U ❑ Addressee
B. Recel by ( Printed Name) C. Date of Delivery
IC - I -to
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 7008 1830 0000 0976 4461
(Transfer from service label)
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 mailpi f
or on the front if space permits.
1. Article Addressed to:
z50 Cf rniRickeP_.;
152 4Z-'JPr R10Y k
ct ) A). C. 213$G G
❑ Agent
Name) I C. Date of Delivery
D. Is deliverv_�dress itterent from item 1? ❑ Yes
/Of C� (F1L71 deliveryladdress below: ❑ No
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) 0 Yes