44060D - Brine

i 4
-LAMA/ ❑DREDGE & FILL q19-?5-
3ENERAL PERMIT Previous permit#
few L Modification [ ]Complete Reissue ilPartial 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 SA NCAC 7 y. /Z G G
❑Rules attached.
t Name l 9i/i CI V- _Pcs)N 'S ,C CG21 '/` Project Location: County
6179 7� 7 p t a/ , d C, f✓ t-✓ Street Address/State Road/Lot#(s) /S 5 U gyp- d
=/9Ss,L1p State 7'4 ZIP 99'G4/6 LA_,e,api Da.
•(330) 'J')-/i22 Fax#( ) Subdivision L A✓cIe/L /2PjoZf
edAgent /7) `CZ wit e ea, Ie/PnJ City aC+o4,✓ 7(Le /3i9c 4 ZIP 2-TY4
❑cw Caw [rA NAS ❑PTS Phone# ( ) `` /R�River Basin tii,7
❑❑OEA ❑HHF ❑IH ❑UBA N/A Adj.Wtr. Body OLd -Gwr d/ C.2 ee t' at /
❑PWS: ❑FC:
yes I PNA yes o Crit.Hab. yes / no Closest Maj.Wtr. Body �/h✓w
•
Project/Activity ( 2 t ✓A7e Pi ea / 2)GC/e
(Scale: / _
ck)length .33'X y/ 2Bn , ' J 'x y!
i s / -f)p2-r j
ier(s) }-
ngth
tuber 4. v ! i
d/Riprap length I
distance offshore
IX distance offshore ! . . .
cannel —_
i
2u I
bic yards Ft yq t i '
se/Boatlift 1
4 Y i yp #Y- i +
ulldozing r--,--. -- ----V—te V ( 4 i_ _--- _
i ri
V \tir 1j
e Length S f
not sure yes no f I 4 i
i
s: not sure yes no ' . t
cum: n/a yes no
yes no I i . f ik . .... L . i .... ; ,_
kttached: yes no3 • • 1 1
ng permit may be required by: e
aes C ► • I See note on back regarding River Basin r

6850
COASTAL FEDERAL BANK
.wint.
R.H. MCCLURE BUILDERS, INC. SUNSET BEACH, NC 28468
�'191.0 NMA 24 CAUSEWAY DR.
>r'= OCEAN ISLE BEACH, NC 28469 67-7235/2532 3/15/2006
[phone]
2
PAY
TO THE NCDENR $ **200.00
ORDER OF
Two Hundred and owl 00***********,.**.***,.*********************************.,**********,.***********************************, DOLLARS
NCDENR
Wilmington, NC 28412 8
4/- 4/ye&c, ( f/k.S'Cal /QU
MEMO 2 Dock Permits AUTHORIZED SI ATURE
11'0068SOO 1: 253 27 23551: L 2580037 L30

o ►oC.k.,
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. gnature
item 4 if Restricted Delivery is desired. 4 11 " � ( gent
• Print your name and address on the reverse f �t Wt=-.0 _ CI Addressee
so that we can return the card to you. Received by Printed Name) C. Date of Delivery
• Attach this card to the back of the mailpiece,
or on the front if space permits. p V C �
D. Is delivery address different from item 1? 0 Yes
1. Article Addressed to: If YES,enter delivery address below: ❑ No
h&+[Ot- Mgr
pow 31'
yr t1. ✓1/ �//1Q/1 3. Fi,:e Type
1 I(� p[p�l✓ rtified Mail 0 Express Mail
egistered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number
(Transfer from service label) 7005 1820 0004 8807 5771
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
--
COMPLETE THIS SECTION ON DELIVERY
SENDER: COMPLETE THIS SECTION
❑Agent
X
• Complete items 1,2,and 3.Also complete Si!
item 4 if Restricted Delivery is desired. ❑Addressee
• Print your name and address on the reverse C. Da of Delivery
so that we can return the card to you. :. -eceiv d by(P d Name)G/ C. _ �
• Attach this card to the back of the mailpiece, Id s/
or on the front if space permits. D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to:
If YES,enter delivery address below: ❑ No
Rt `. LaryijleAtto
404 Ora,- /L-o--
1
�JtMhOm l� ai-103 3.;Tice Type
Certified Mail ❑Express Mail
❑ Registered 0 Return Receipt for Merchandise
❑ Insured Mail ❑C.O.D.