42043D - Fennell

'LAMA /` DREDGE & FILL N?,
ENERAL PERMIT Previous permit#
w iModification !Complete Reissue Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural esources ��11
oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7H, a//i
es attached.
Name ke14 re pi /i'/l Project Location: County c j,_ k s C/ C
ZS 2.-5k/SaA lion O,i Street Address/State Road/Lot#(s)
Gk 20014 State/LL ZIP i s 1iirf/1�
(la 77 5-76/3 Fax# ( ) Subdivision
:d Agent City ZIP
CW Al*: 11A "€S ❑PTS Phone# ( ) River Basin 4094,
▪OFA HHF IH C UBA N/A Adj.Wtr. Body 4 r1A/t 5/0•' at n
▪ PWS: ❑FC:
(es / no PNA d;:>/ no Crit. Hab. no Closest Maj.Wtr. Body /4t/,0
Project/Activity i4 D/O e'd Pv/Lh ODIC
(Scale: Oa
k)length
40.74
:s)
sr(s)
gth
fiber
yiprap length GV
distance offshore
distance offshore
tan �'u �,
mnel ycto
icy �(
p "1
e/Boatlift •
Ildozing i G GO
.. r
r
/Length ' 2 CZ
L4 i4!6/ f bier)
not sure yes �r
not sure yes
im: n/a yes •
yes •
:cached: yes .. J
g permit may be required by: VG I[ /4q& See note on back regarding River Basin ru

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ER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
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iplete items 1,2,and 3.Also complete A. Signat .��
14 if Restricted Delivery is desired. X L VAgent
t your name and address on the reverse L. = 1- ••J--' ❑Addressee
hat we can return the card to you. : •eceived b Pri fed Name) C. Date f Delivery
ch this card to the back of the mailpiece, Q
n the front if space permits. Fv A)by
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D. Is delivery address different from item 1? ❑Yes
le Addressed to: If YES,enter delivery address below: 94(o
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3. Service Type
NWrP.
D[Certified Mail ❑ Express Mail T — 3 c-
❑ Registered la Return Receipt for Merchandise j r17 3 a
0 Insured Mail ElC.O.D. c o O
4. Restricted Delivery?(Extra Fee) 0 Yes �1 w n r m
e Number ru 0
sfer from service label) 7003 1680 0000 8279 7877 �'
l ru c� CD ,-.1
n 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 'C' w v cLrl
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