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;ENERAL PERMIT Previous permit#
!IGew Modification _- Complete Reissue Partial Reissue Date previous permit issued
•ized 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 N ..1 \O 0 `, 1"t.-��
ARules attached.
t Name To).11 C,Li Ok_A-) Project Location: County (►J,-,1---t---)
L3\a 0 on..-TA A v./ oo DS '(L Street Address/State Road/Lot#(s)
,L)4/-.1 `rLt.-L-e State 0Z-- ZIP1-8 c1S5 GN AC,wLL - S11o(. b S
P•N\-a)385- 1° 'i Fax# ( ) Subdivision ee4Aort)vt/TG L e=N-I t r5
ed Agent T�oNN...) GAS SI 0 . City SaEAb5 F£2 ) ZIP 2-56i1
-CW
_ UR* i�rA QEs' ❑PTS Phone# ( ) River Basin al
L OEA El HHF ❑1H UBA ❑N/A
Adj.Wtr. Body AbvriL IL % AI (el h
L PWS: III FC:
no yes PNA ye / no Crit. Hab. yes / no Closest Maj.Wtr. Body OE v✓ ii—'lYC n-
Project✓Activity 1°-)5T A L )--)>r Di V S s 1 L ('S.{-\ - v.7 11 0' t,-)1 +-145
X 1.5 0 ' i t:(1. ,..,..)/ I S x o, " 4-1 EN i) S)1 2.4 + Z,'f, 11- t Al .,,al. (Scale:) ' Ll
:k)length h X 1 5-0 __ ,
(s) ► Sx 9 0 c. ,a SI KtS
7 , 3 �
ier(s) 7)t11. f 3 y.1 L1 r. 0.
igth Z ti J
nber ' ♦ •
1/Riprap length
distance offshore )L
x distance offshore CA
cannel I ►��v
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ip
se/Boatlift — \-1 L1-
ulldozing
0-
1.
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e Length r 1 e r L 4not sure yes no
s: not sure yes no
ium: n/a yes ® L,
yes
attached: yes / --^-
ng permit may be required by:0'a5 t-°''''" w ' ,_ I See note on back regarding River Basin r

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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
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item 4 if Restricted Delivery is desired. 0 Age
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1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes
If YES,enter delivery address below: 0 No
4`,-(_ V./ILL—Ms 37L
/ !,�ti�7Xi
C i/9,L'L /7//4L /`/,( - 3. Service Type
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7,,-/ 7 ❑ Registered ❑ Return Receipt for Mercha
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2. Article Number 7004 2890 0003 7343 8763
(Transfer from service label)
PS Form 381 1,February 2004 Domestic Return Receipt 102595-o24
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