39867D - Gray

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CAMAS/ ❑DREDGE & FILL
IENERAL PERMIT Previous permit# s1--1t-11
New ❑Modification Complete Reissue ❑Partial Reiss a Date previous permit issued '(•ail-
zed by the State of North Carolina,Department of Environment and t I Resources
oastal Resources Commission in an area of environmental concern pu ant to 15A NCAC Rules attached.
:Name fr,;( i), ,c r, i_.
Project Location: County /'I • ; ( ' &
/iS< l,%.. �;if / 4_,GJ2:(i:.;�
Street Address/State Road/Lot#(s) !, ',-'-
C. _
(10" , State ZIP .
(9iU) ,.t t�c r - �' �k.3 7S Fax
) Subdivision
�
ed Agent
City .�< < p iy ZIP .<.y i U e
River Basin 1_t r:r+I
CW AW E]PTA El ES ❑PTS Phone# ( )❑oEA ElHHF DIIH IIIUBA ❑N/A Adj.Wtr. Body r%/t<JCL: (nat /i
❑PWS: III FC:
Closest Maj.Wtr. Body lLt/ !c t 1
yes / no PNA yes / no Crit.Hab. yes / no
f Project/Activity
(Scale:
)ck)length _- 7 5 r S' } IIMMt-
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+
n(s) /t/xfC, 1 —TM
xn�!) ---I t . . ,.
eier(s) _ ® 1 1i
ength 1
amber
ad/Riprap length GG
1
1 1 { ..... 1 --
✓gdistance offshore • ,
t
lax distance offshore i. ;-- t
channel i ' —. .-.. ' ; I f..
L
ubic yards .....__!..._ __...... 1 -- I I
...
amp -
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ruse/Boatliftlilillarjeli , `�
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MMIMMNIIMINIMIMINI:
Bulldozing V
. lianiMillnlirMalll Ir21100111111EMILVIIMINIIIMPRIMINI
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dine Length 1 ,
1
not sure yes no)
+ags: not sure yes no +1 —
i I
torium: n/a yes no
Ds: yes no I — '_. �.. ., , —. _ —
ar Attached: yes no 1
ilding permit may be required by: ( i-t(i)5u ),Ck.,Cct'' ' /,y. I See note on back regarding River Basil

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: e ne -Gi L. ?rasi
ADDITIONAL NAMES: /9,'3 i 6ruy
AEC DESIG: �C%Lv P T DEVELOP AREA:__.Q L PROJ DESC: f9 -/2
(Will only take 6) (Will only take I)
WORK: pe 75-
,
(Will only take 4)
TE /eI z0
MAINT:
(Will only take 4)
IMP: /2t0) Zv-o
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: // 4/00 4/26/0f
CAMA MAJOR DEVEL REQUIRED: ifzG/o$- 11/2-G/O4-

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