45818D - Harts

t r
LAMA/ ❑DREDGE & FILL
iENERAL PERMIT Previous permit#
Jew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
:ed by the State of North Carolina, Department of Environment and Natural Resources iastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7 H. , Q
❑Rules attached.
Name AiL_ '/ Fj .5 Project Location: County Pt N Q1✓IL
?,'�j5 C r- . E- Q€,(.(,L 12.D, \A.1 Street Address/State Road/Lot#(s)
)(Ai-./ INT State NC ZIP 2"`1 S 7 Ss0'1/1C
i 0) b 20—11-1'f 1 Fax#( ) Subdivision S W A !'LAi-.cirtm o f
dAgent �RIZIL E1 M S City j2oC9 1 O!N i ZIP Z84-S"
❑Cw •t`W 6GPTA ❑ES ❑PTS Phone# ( ) River Basin (APE
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body IQ -e.,- we - fOir
❑PWS: ❑FC:
?s ("hp, PNA ®/ no Crit.Hab. yes / no Closest Maj.Wtr. Body. Nit-
, �7 E
'reject/Activity INSTALL IJFin! 15OATLaFf ilD E,VIST1Qte.4 13iaz./Dx.LL
UC�U( (Scale: I"
)length
l
i'
;tin '
ber afrP •
_ F.
Riprap length OF! f --
listance offshore • i i
distance offshore u
i
nnel
— ✓ --
1 Pt
:yards T--,�e� �•�
�- j� �� t..f... sv+
i , r .... _....
tuft 13 x Pi. s to pD ic.
Idozing
.
-
Length > I' -_
not sure yes rh3 + y 1i\ii , ' - '' _
not sure yes o")' —— — .r........
m: n/a yes v%)
r
yes no.
lathed: yes Fa) i ,

G'lentents Marine construction 8011
910 270-9110,NG"A.0 4356789 Q 66 301531
577,NC J`Figkway 210 W Date /v 365
}fampstead,NC 28443
Pay to the id/O e I $/
01,
t ".(�L Dollars lJ
HRSC CITIZENS J65
BANKnAN�! FlrnfI on�Bank61iu�t Company
l� H�mpd��d,N.C.YB41J
TnS
.com •ti .�
For 6,t/CfiI
I:0 5 3 L00 3001:00 3 5 3 20 L LB0 BOLL
MEIN " SIM . w sWr'c'071:TAL
.

Oai,Pr
O ��
O 0 7-
0
Ni)

Clements Marine Construction
NCDENR Letter of authorization of Agent
This letter is to grant permission for Mark Clements, DBA,Clements Marine
Construction to apply for,and obtain permits, and all information needed on my behalf
for projects building permits,NCDENR permits,or any permits required from the State
or Co 'es in which work will be performed for me.
j ;if do understand that by allowing Mr. Clements to obtain such permits that this will in
no way release me of any responsibilities to codes,or environmental required permits.
AMIg y /1/49RJS date (o%/Zad6
Print n e
date 6//1-/24D
gna e
7/0 600 24 ?/ (D z 3g/9--
Contact numbers

SENDER: COMPLETE THIS SECTION
COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Signature
0 Agent
item 4 if Restricted Delivery is desired. X 0 Addressee
■ Print your name and address on the reverse
so that we can return the card to you. . Received by(Printed Name) C. pa elivery
• Attach this card to the back of the mailpiece, rA,�nb' L / t1 Lrn Y17V1�1tln
or on the front if space permits. b/
. Is delivery address ifferent from item 1?
es
1. Article Addressed to: If YES,enter delivery address below: 0 No
FRANk Ru cc6
z 96 3 S FCAR/ POP
tit t DR.
/
TRA Ire •AR7 IA14/ 3 3. Serve pe
..,•- Z,�7 Certified Mail 0 Express Mail
❑Registered 0 Return Receipt for Merchandise
❑ Insured Mail 0 C.O.D. -
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number
(Transfer from service lahj!l
01 618 5 8848
PS Form 3811, Fet
7 1
10 °D 1 02595 02-M-1
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. �l�'`.�- � ❑Agent
• Print your name and address on the reverse X BAP I '' kAlrrrtAT�+� ❑Addressee
so that we can return the card to you. g Reved by(Printed Name) C. Date of D ry
• Attach this card to the back of the mailpiece, ,PQ�_ �- � �t„ (p—
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: o
Ferri/ v',N ,ivMsQFs
.5' Casru,4v�
Ci?sn - iii/91vc n/�'7 3. Service Type
Z G 7 rtified Mail 0 Express Mail
0 Registered 0 Return Receipt for Merchandise
❑ Insured Mail 0 C.O.D.
• 4. Restricted Delivery?(Extra Fee) 0 Yes