42036D - Gore

AMA/ I DREbGE & FILL Viy1-1---r N° 4
IENERAL PERMIT Previous permit#
New (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 15A NCAC 7 N ./-)°C)
M'(ules attached.
Name a`,I t Go Rom. Project Location: County 3I ►it,Swic/
;�- rvk C ke l N-C.. - Street Address/State Road/Lot#(s) 7 a FA-i r/►'
Ctnn4.9-Al State St— ZIP 3 cf Oa V
($03)Li1S--(Sb)-Fax#( ) Subdivision
:d Agent J.W,ivi in eviz City Q(6-4''J V e 3Mcii ZIP ..)ri 6
❑CW LW* ii.,BS� ❑PTS Phone# ( ) River Basin
E OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Bodyl"/4.ve UP-F. 4-SI /W (nat n
❑PWS: I FC:
Closest Maj.Wtr. Body 014,4(-
vs /� PNA yes / 2 Crit. Hab. yes / no
Project/Activity 4?enI-eli7f Ok ia7C, p G1oi4-7'1.7 t oC-
J (Scale:/ -
k)length '/f(`IT r i1'/ .3 'x/4 • yeigth,70 61.4 A ( --
s)
:r(s) ''""""""t
0
gth _ 6 i
iber
/Riprap length
disttice offshore
:distance offshore `� +0--- --------...._.._..,_-
tnnel �` Jf
is yards i t
e/Boatlift 1 ' -_-
it til It
Ildozing •
-o4 f k'Po
Length 9 -,C fr' (II6
A St
not sure yes ny)
_- ) i not sure yes C7o`d)
im: n/a yes
yes
cached: yes no
g permit may be required by: L'Cc/1/'---3/E ,</ See note on back regarding River Basin ru

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