53933D - Goforth

❑CAMA / E DREDGE & FILL 5
GENERAL PERMIT Previous permit#
?New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
prized by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7 j..1- . i 2-03
f V) Rules attached.
nt Name �
G O `i�- Project Location: County
' I r i-- ki A,j 656 Street Address/State Road/Lot#(s)
-pc,,y State , . ZIP 273 7/ (gel U ro F . yrZ`fl-f twK' .
4E'(11C) Si 2 —15tolz, Fax#( ) Subdivision
zed Agent City _2, ( l s-LitiN.,49 ZIP 7,1-14 t1
I ❑CW LW ❑❑1'A 8 ❑PTS Phone# ( ) River Basin C Aee
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body
❑PWS: ❑FC: --
yes /Ito i PNA -tes)/ no Crit.Hab. yes / no Closest Maj.Wtr. Body i WNW/
f Project/Activity R ,,/ tI\2 ,,,l (--,,,l' , ) -,t ,
/ (Scale: I"x=1
ick)length "4033'.c 41 _' (Fp is,Ak Y1?1J QD t�XcC i:t-,r= 0"(4-oC+`1;¶-o lP 1- p► cASTrl NK
n(s) e L `-.�
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:ngth j — --—
mber I
d/Riprap length i I _ -._.--.
g distance offshore A
ix distance offshore
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Dic yards tiS I 'YG flw!A(. d f -
use/Boatlift � i 1$ I
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um: n/a yes r� , b 4 u L :E r �� l -� —
yes
1tached: yes no r
rg permit may be required by: iA114' t cL +0 See note on back regarding River Basin ru

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a; SENDER:
:ci •Complete items 1 and/or 2 for additional services. I also wish to receive the
rt.; ■Complete items 3,4a,and 4b. following services(for an
ry •Print your name and address on the reverse of this form so that we can return this extra fee):
ai
12 card to you.
dd •Attach this form to the front of the mailpiece,or on the back if space does not 1.El Addressee's Address u
w permit.
■Write"Return Receipt Requested"on the mailpiece below the article number. 2•0 Restricted Delivery N
r •The Return Receipt will show to whom the article was delivered and the date
delivered. Consult postmaster for fee. a
0 3.Article Addressed to: 4a.Article Number 0
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7. Date of Deliv b o
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6. Ignature: (Addresse: . . •nt) e' i .c
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H PS Form 3811,December 1994 102595-98-13-0229
Domestic Return Receipt
SENDER:
•Complete items 1 and/or 2 for additional services.■Complete items 3,4a,and 4b. I also wish to receive the
fo
d •Print your name and address on the reverse of this form so that we can return this exltra lowing fee)services(for an card to you.
m ■Attach this form to the front of the mailpiece,or on the back if space does not
permit. 1.❑ Addressee's Address w
t ■Write"Return Receipt Requested"on the mailpiece below the article number. 2.❑ Restricted Delivery y`
■The Return Receipt will show to whom the article was delivered and the date COdelivered.
0 3.Article Addressed to: Consult postmaster for fee. a
y 4a.Article Number
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