52068D - Gordon-Frieze

CAMA / DREDGE & FILL
GENERAL PERMIT Previous permit#
I N1`w Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
Drized 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 7N /Z. C)
Iles attached.
nt Name ff_-, ., , — (jTh J - lE Project Location: County 1-2E:I9 tc
s Street Address/State Road/Lot#(s) I-c=T (---
N tt`,;rt5 r%L.�C. i,. - _State ZIP — j .i t, v 1 L i ._,r) jai_ t 'Z E
0 ( . ) 2 j - 1 Fax#( ) Subdivision E/\&1 t`> w A 1r t k
zed Agent AL e City ("' '11\1)SRAO ZIP '84
d cW EW .E.,PTA ES ❑PTS Phone# ( ) River Basin (i
OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body I C �
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PWS: ❑FC:
yes / no PNA (' / no Crit.Hab. yes / no Closest Maj.Wtr. Body A\W yv
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ock)length
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pier(s) i
ength 2
umber i
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ig distance offshore r P {
lax distance offshore 1/1 ,'"-2e1'4-L '� colrn
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ibic yards ,
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ne Length J�
not sure yes `no _
gs: not sure yes (no i L.ci ti 1 L„t 5,
,rium: n/a yes no (� ( ::
yes no jk`(L 6712i 40.)16 �,1 ,r L., U1(4.- fi2,-, '
Attached: yes no , i
ling permit may be required by: U See note on back regarding River Basin
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b17A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
ael F. Easley, Governor Charles S.Jones,Director William G. Ross Jr., Sc
Authorized Agent Consent Agreement
AN i I N o RA Cot16 K RJ c t o is hereby authorized to act on my beh;
(Printed Name of Agent)
er to obtain any CAMA permit(s) required for the property listed below. The authorization is limited to
'ic activities described in the attached sketch.
\TION OF PROJECT:
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'ERTY OWNER MAILING ADDRESS:
0. 130X \3 a.R
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PHONE NO. Q10-age- a51'-j
IORIZED AGENT MAILING ADDRESS:
A. LAIAE
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APHONE NO. 9/0-3 a2�.�`�7�-
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(llama PEBAJD)
IMPEIEWNWiT7ISVOCUO NBC/ -
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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Si. ature
item 4 if Restricted Delivery is desired. 0 Agent
• Print your name and address on the reverse X' / '" 0 Addressee
so that we can return the card to you. B. eived by(Pr(pted Na* C. Date of Delivery
• Attach this card to the back of the mailpiece,
or on the front if space permits. '(r I ► em-
D. Is delivery address differenf-(rom Rem 1? El Yes
1. Article Addressed to:
If YES,enter delivery address below: ❑ No
SPgLT F No u j ,Lc
c'.o. Box )3. Fs
tz 2k6 5 q)i.t.E B E-A)cN 1-4( 3. Service Type
LO rtified Mail ❑Express Mail
❑ Registered ❑Return Receipt for Merchandise
C u l f51O ❑ Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7006 2150 0003 2158 2934
(Transfer from service label)
PS Form 3811,February 2004 Domestic Retum Receipt 102595-02-M-1540