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CAMA / E7,bREDGE & FILL
3ENERAL PERMIT Previous permit#
'New Modification Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources �/
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC ?// , 1/pp
144
❑Rules attached.
t Name 6�j Wh/f( Project Location: County /vGty.- /1�lty7pk/lj
2 Ir1 4 Hen .r , Street Address/State Road/ Lot#(s)
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VI IA iP) 1.1 State ZIP - :5 j./
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:ed Agent Ei� Mail" City 5l ZIP
❑CW 4teW &1 A Da ❑PTS Phone# ( )// soi. .� //++River Basin .,
❑OEA ElHHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body% #4v
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❑ PWS: ❑FC: //� I- /
yes / no PNA yes / 6, Crit.Hab. yes / no Closest Maj.Wtr. Body / So��+'o ti
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s: not sure yes T/ ^ /2r'G M•0 /"'' re� l+'.ir ter)ol/7Ct' 44�1�1
ium: n/a yes / ` l�
yes 1A A Y .r 22 / $44e5 Dr.
4ttached: A"A no —. = —--- —
ng permit may be required by: iW " (� , See note on back regarding River Basin ri

[F1 S e c u r i t y enhanced document See back� for d e!ail (.met., _..w.• ---
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ALLIED MARINE CONTRACTORS, LLC 08-03 2865
910-367-2159
92 HAROLDCT.
HAMPSTEAD, �J/7/ .7 66-19/5300NC
NNC 28443 DATE
PAY �/
ORDER OF ���C,L�� NR Is '/o U 1
FG'i-tr" 744-!-1 DOLLARS nnti
Bank ofAmerica ,
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ACH R/T 053000196 0
FOR 0 /`i--€, Cod Wd43 AP e
II.00 2 8 6 5 0 1:053000 L961: 00068474 7381
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AT&
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
:hael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., S
Authorized Agent Consent Agreement
411110t/ 74-11't- 6riki21-41-i �014101 454,1) is hereby authorized to act on my bet.
(Printed Name of Agent)
.der to obtain any CAMA permit(s) required for the property listed below. The authorization is limited tc
;ific activities described in the attached sketch.
:ATION OF PROJECT:
l /1) F1 /3r
w),,,.,i,f.,,\
1PERTY OWNER MAILING ADDRESS:
1i01,241) 174A41 �
PHONE NO. o?y—/I!'
HORIZED AGENT MAILING ADDRESS:
9a *id 6
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1.-/onfA A
PHONE NO. CO-0)3D - DS 30
ature of Property Owner: 141-/