43295D - Lewis

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JCAMA/ r DREDGE & 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
2oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7 N . I SOQ , 2 JJQ
X Rules attached.
t Name f Y .QQ►l. LEI t./ 3 __- Project Location: County ivs L.,..1,....--"
1-h S L.a✓ w 2 S {t Street Address/State Road/Lot#(s)
r` QS\ t A State'-) L ZIP':' y 143 ) Z I)IA r Cr 4- S_-..
(C 1 3) Z ) - 21 9LI Fax#( ) Subdivision
:ed Agent City Ski,:-. ans Ft.':ril&�i ZIP Z3L/
ii Cw L3EW 1 TA ❑ES PTS Phone# ( ) River Basin )M1 i E
OEA ❑HHF ❑IH ❑UBA N/A Adj.Wtr. Body 1\L v..) v'/ (nat 4
I_: PWS: ❑FC:
no PNA yes /�n� Crit.Hab. yes / no Closest Maj.Wtr. Body kJ C w CI v +-�--
yes /
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!x distance offshore �—
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f /not sure yes no Hit _ r
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s: not sure yes �NJ
•cum: n/a yes (RC) I
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yes
4ttached: yes ® .- I
ng permit may be required by: ‘FJ 1.3 L3,....-.) Cat....T1 See note on back regarding River Basin r

(fl Security enhanced doc u men t See back fur details.f:11 —
2687 1
I; MARK LEWIS CREW BOATS, INC. i
c 405 LEWIS ROAD
HAMPSTEAD,NC 28443 66-30i531
DATE 9' �' 365
PAY
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FIRST CITIZENS 365
BANK Hmd NBCkdTt Company
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