40433D - Galarde

LAMA/ DREDGE & FILL �`M9 4(
ENERAL PERMIT 7--- Previous permit#
\lew Modification 'Complete Reissue ❑Partial Reissue Date previous permit issued
zed by the State of North Carolina,Department of Environment and Natural Resources n�
)astal Resources Commission in an area of environmental concern pursuant to 15A NCAC •
Rules attached.
Name 7Ohh CX-+ Project Location: Countyis-. /4 44 is-. ai"
$I a ,,,,firr,,h f G 1. ?w Dr. Street Address/State Road/Lot#(s)
0 ini/h /14 State/i ZIP Ze.105 g /2 1N/�L I,�fr'e`''' 2E.
S •day ' Fax# ` -- Subdivision .SN, /'d/ii
:d Agent J/0107 /t/9,a City h"(4*/,*Of ZIP 7.1 y
'�CW
q fA ❑PTS Phone# ( ) ✓.5 ') River Basin
/�
OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body Skim./ ` '4 (nat In
L I PWS: LIFC:
des /�i jo PNA es / no Crit.Hab. yes / no Closest Maj.Wtr. Body �1V-40 10,, ��
Project/Activity C G►',,Sf/"'L,, f /71`-i' p/!✓ / /�/G�'f' ''c/Y' /%. 1
/7/ / / /
4eSa f//� (Scale: ��
:k)length 5)c O L__ — ..
(s) 4 'x26 ' , X ,
ier(s) 4,
ngth _
tuber
d/Riprap length gj ,
distance offshore uc distance offshore �ij/if9,rl Cif
i t .
cannel
/
bic yards 1 $ 6.lev' ', ,�r
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is oa ft /OX /3 C.Y/^t'l! k:,l.I therl%'f /s!Gii!✓' / e'}.-V _/) 1o'" /
lulldozing
/ , • a
CS f,
^^ / /cry fn.
ie Length �MS L
/AI,t/. f'.�2'-/-iy
not sure yes � �, ,
EA
(S"/ .7 ':r j/i!,s-- „P'
gs: not sure yes
,rium: n/a yes
yes
Attached: yes 6
ling permit may be required by: /(Avft I-4ioVL,-- See note on back regarding River Basin

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME:
ADDITIONAL NAMES: Jl y /(/O/"
AEC DESIG: DEVELOP AREA: , U.0 r PROJ DESC: f -
(Will only take 6) (Will only take 1)
WORK: in/Z S / 5
(Will only take 4) //•
MAINT:
(Will only take 4)
IMP: .1(6c
(will only take 6) !„
ACTION EXPIRATION
DREDGE&FILL REQUIRED:
CAMA MAJOR DEVEL REQUIRED:

L , I SI0 N ( CPAADi «'HIV 'R FO .�ti
i 1�C NT PA.};1Ati' FROPERi_O1_KIC - '.—
Name of Individual Applying For Permit: «`
k 2,e ---$014,4 - fat je
Address of Property: g i
(Lot ortreet#, Street or Road)
L! ( � g� Oq
�� i 1. G���'i 1 %
-r----
(City and Coun.'
adjacent to the above-referenced-property. The individ
I hereby certify that I own proPertY �
e
t
applying for this permit has described to me as shown on the attached drawing h withevomen tie
are proposing. A description or drawing, with dimensions, should be prove
Lc; I have no objections to this proposal.
please write the Division of Goa
If you have objections to what is being rdV'Vil�i ton, NC 28405 or call 910-395-3
Management, 127 Cardinal Drive Extension,
within 10 days of receipt of this notice. No response is considered the same as no objectic
you have been notified by Certified Ma41
fi• 1 I i •
`A/fr mooringpilings, breakwater, boat house or boat lift mu
I understand that a pier, dock,
set bck a minimum distance of 15' from my area of riparian access waived by me
you wish to waive the setback, you must initial the appropriate
blank below.)
Y
'`�71'" I do wish to waive the 15' setback requirement.
1, , I igssa wish to waive the 15' setback requirement.
/
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Slit Name Date
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OMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
items 1,2,and 3.Also complete A. • ture
0 Agent
• tricted Deliveryis desired. X r ©Addressee
name and address on the reverse
a can return the card to you. eceived by,(P$nted Name) C. ate of Delivery
s card to the back of the mailpiece, /,,A) >/e>/rn,.) -3/3�G'j ®„AR,AND Sr_E Xr;
front if space permits. / Yes A ` E
D. Is deliveryaddress different from item 1? $=_- J-I'�'
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Tressed to: It YES,enter delivery address below: p G—�
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4. Restricted Delivery?(Extra Fee) 0 Yes e'
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311,February 2004 Domestic Return Receipt
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City,State,Z1Pr4 ,°
PS Form 3800,June 2002
See Reverse for Instructions
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