40354D - Montgomery

CAMA 1 E DREDGE & FILL N9 L
EN E.RAL PERMIT Previous permit#
slew Modification ❑Complete Reissue SPartial Reissue Date previous permit issued
red by the State of North Carolina,Department of Environment and Natural Resources
aastal Resources Commission in an area of environmental concern pursuant to ISA NCAC 7/1 /100, 7y/20e
� D Rules attached.
Name j jLQL'7 ./ll AJT�Qn9-e / Project Location: County pr. N$GJi a___,
3& Si (:41L 06,E L,Q r Street Address/State Road/Lot#(s)
rre. E 04,j S State At, ZIP ( ig2 Y� c L0A4-TGN AL
71Ot)q&-1?(© Fax#( ) Subdivision nn__
1 Agent �vl4G� q/d-��D—�/D City i`tt�1 E.v � 1G�_- -_ _. ZIP 2
IE‘W tIW P'//PTA► ES ❑PTS Phone# ( ) _ River Basin Lt,ItAl
❑ore► 0 HHF ❑IH 0 UBA 0 WA Adj.Wtr. Body 4/G(.. ei/ ,f fl
❑ PWS: ❑FC: �►
44-1
s / no PNA yes /� Crit.Hab. yes / no Closest Maj.Wtr. Body 4(11
;roject/Activity pro fOs -c) Pie/ .. to(Ff' /2 1�/Zy/ Q-r 2,4) ��k,`/ '�(� 7i 41✓6 pc4
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length 4Vdla ET
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to tit 'r C�1'C7 cvt r
th F TC -,<vi 1//Wiii . - a 4G __,
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Riprap length_ ,,7/ /5, I, - FC.ATFt4rLM
istance offshore // A i L 111 ift• .
distance offshore II Lkb
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Lift W.Z
Boatlift / 13 1
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dozing / Pt9 G t r „,- li
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not sure yes ( o -,/-(6ty c`-� ..{t°)
not sure yes t�OvM� `i. : _'t.7! _ aaos
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n/a yes ( ga i r. —
yes pn/rt 6014 ( y cwv �
ached: yes 11 �� Z / -
permit may be required by: 4,(/).E.A.) C��+�( l See note on back regarding River Basin

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WACCAMAW
-_,....--,BANK
Supibt NC 28462
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