41402D - Duez

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:AMA/ 12 DREDGE & ALL
ENERAL PERMIT Previous permit#
few _Modification _iComplete Reissue Partial Reissue Date previous permit issued
ted by the State of North Carolina,Department of Environment and Natural Resources 9 // - /2 D��
)astal Resources Commission in an area of environmental concern pursuant to 15A NCAC ��Rules attached.
NameAPZ
�' b, ��€ Project Location: County /" /�ch'ildl
//9 A 19,, 0 ' , Street Address/State Road/Lot#(s)
44n u'f�/ bii ' State/tii ZIP Z gy// ';-;e/.'ye
(90) . 0• 49e12 Z Fax#( ) Subdivision
:d Agent ....1!✓LIP1 j ,t/e/ +y� City Ai// 147/k yi 4'9 ZIP Z g 4
CICW [iW E PTA E ES ❑PTS Phone# ( ) 5' a4J' River Basin Ce�<
DIoEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body Ayes &Pe'r/` (rle/n
EllPWS: ❑FC:,t� / � �L/f-1
des / PNA �//ono Crit.Hab. yes / no
Closest Maj.Wtr. Body
Project/Activity ( ,rhSf/'//e/ G rr� Ar7;61?', //!/�� 5 �e'e�
_/e4/ ' t' /�f// �/am'. (Scale: / "
:k)length GX /92 / r -�`�/ ,
i(s) �o X 2 O "VC r �/
ier(s) *' y ♦t l ^'°�
ngthri
G
tuber /p,15 ��.,1(}��
d/Riprap length /� 1 1`
distance offshore 1 n k }
ix distance offshore 1"
nannel
bic yards \ I. -"gi
4 -A r'G,r/ fl .
lip �t�/ {^ j_
Jse%"" ,f .6 J- T ks ' "
iulldozing_
( Z \
/y l
ne Length /�v / i
not sure yes a) \
gs: not sure yes ep
! ti� ,i Ale .
irium: n/a yes L
yes a PI, j)uc.9 p�"l '/' / P
Attached: C' no �,/
ling permit may be required by: /! 6'.....c2' . I I See note on back regarding River Basin
--1 -, ... , / .-, / _. _ /_or ,./

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i 3Nrt aauoa iv 010d'SS3tla0V NU1113U 3H1 d0
MOM 3N101.31013AM d0 d011V 1:132010U-S 301nd
R: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
.fete items 1,2,and 3.Also complete A. ign�ltu
if Restricted Deliveryis desired. / i ❑Agent
your name and address on the reverse X�1 ❑Addressee
at we can return the card to you. B. Received by(Pri d .ame) of Delive
h this card to the back of the mailpiece, /6 `e.)
the front if space permits.
D. Is delivery address different from item 1? 0 Yes .
Addressed to: If YES,enter delivery address below: ❑ No
lt S)h e y /-1—Ai�
I p 3. Ice Type I�
' p JIv---1.-` /..�C as� '' Ce�Rified Mail CI Express Mail _ „
�" 1 ❑ Registered ❑ Return Receipt for Merchandise i; µ
�J 0 Insured Mail 0 C.O.D. .
,1 •i z f 'p C<
4. Restricted Delivery?(Extra Fee) 0 Yes 'T II
r Fo
o �_
cle Number W
7004 2510 0002 9726 3707 ,
nsfer from service label) O �` o
flt
rm 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 ';I h. I
1NOI11
tl 3N 1013dO13`n SU3tl0OV Know 3ail _ l ••
AN3 iO 1011V tlSX3nLS 33y1r CO ` .4.....,DER:COMPLETE THIS SECTION COMPLETE'HIS SECTION ON DELIVERY 6 ,
O
Complete items 1,2,and 3.Also complete A. Signature ru
tern 4 if Restricted Delivery is desired. X �1�� 0 Agent ru N
tint your name and address on the reverse _ 1 IH
.o that we can return the card to you. � FJAoDdr :; r _ 1
\ttach this card to the back of the mailpiece, B. ReQeiv9!!�y(Printed!Tame) C. Date of Deli 0-1
x on the front if space permits. ) -�� ` ...
Uncle Addressed to: r :%k i D. Is delivery address different from item 1? 0 Yes =
If YES,enter delivery address below: ❑ Nomi
�,, ► r
o '
' 0 ���� o% Lu
r �
h,,in,.. irft
02
8 l) 3. Service Type
t.ICertified Mail 0 Express Mail t
t 0 Registered 0 Return Receipt for Merchandise
0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
rticle Number
iansfer from service label) 7004 2 510 0002 9726 3 714
V
orm 3811, February 2004 Domestic Return Receipt 102595-02-M-154o r a
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tiarne of Individua pe.^.Ti1C: C�: Applying For .
Address of Property
(Lot or Street#, Street or` .oad)
(City and County)
I hereby certify that I own property adjacent to the above-refereneed..property.
The indivic
f this ermithas described to me as shown on the attached drawing the withdevelopme this eflt
applying si P pg with dimensions, should be provide
ttt
are proposing. A description or drawing,
I have no objeeti.ons to this proposal.
tease write the Division of Coti
If you have objections to what is being,�ar°Wilxni$toAi NC �8405 or call 914.395-:
posed, p
Management, 127 Cardinal Drive Extension,
within 1 days da s of receipt of this notice. No response is considered the same as no objecti
you have been notified by Certified ;'tail.
at lift
I und
erstand that a pier, dock, mooring pilings, breakwater, boat houses moaed by mt
set bck a minimum distance of 15` from my riparian
you wish t waiv - he setback, you must initial the appropriate blank below.)
I do wish to waive the 1 o setbackrequirement,
I io not wish to waive the 13' setback requirement.
WOW
C`i en "Am P Date ...r..��r.

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Created 01/01/05 N. • �� _
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