42386D - Jones

6AMA/ -DREDGE & FILL VVV yI b- ' 'y ' `
IENERAL PERMIT Previous permit#
New ❑Modification -Complete Reissue -Partial Reissue Date previous permit issued
zed by the State of North Carolina,Department of Environment and Natural Resources
oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7 H. / e lestttached.
Name C, %Sly ✓©.ie�j Project Location: County +Pn ./&' 1O
Lot /D ,GtJG71-Prf Street Address/State Road/Lot#(s)
A#p 5 te4Ot l State�A�e�ZIP Zi3910 L
(I/O ) Fax# ( ) Subdivision
zd Agent City ZIP
❑CW ❑EW rt•PtA DES" ❑PTS Phone# ( ) River Basin 4tle ,
❑OEA ❑HHF E IH - UBA ❑N/A Adj.Wtr. Body 104/ (nat
❑ PWS: ❑FC: Closest Maj.Wtr. Body Al-,Ptyes / ? PNA yes /65) Grit.Hab. /yee`s//�r d)
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not sure yes ,
gs: not sure yes ".
Irium: n/a yes — ty
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Attached: yes n
ling permit may be required by: //1I4/ f r I See note on back regarding River Basin
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': COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
lete items 1,2,and 3.Also complete A. Signatu : — --- .
if Restricted Delivery is desired. X , ., ``ems Agent
our name and address on the reverse II Addressee
t we can return the card to you. B. Received by(Printed N-me) C. I-te o Deliverp-
this card to the back of the mailpiece, Ds
the front if space permits. ' /0 ' '
D. Is delivery address different from item 1 ❑Yes
Addressed to: l If YES,enter delivery address below: 0 No
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0. 5cc7 /G 2; '
�✓� /s1� 3. Service Type
)01)0, '" // 0 Certified Mail 0 Depress Mail
XV
❑Registered 0 Return Receipt for Merchandise ,unaoine SAFEN oca.ke K,Ko
❑ Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes - O 1k O y
Number 7005 0390 0002 4358 7928 ❑ mm
r from service label) 0 O
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3811,February 2004 Domestic Return Receipt 102595-02-M-1540 17
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