40452D - Sims

AMA/ ❑DREDGE & FILL N9 A
liEN ERAL PERMIT Previous permit#
New -Modification —Complete Reissue —Partial Reissue Date previous permit issued
rized by the State of North Carolina,Department of Environment and Natural Resources �1
2oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC r/ • 7000
/ ❑Rules atta hed.
t Name VI a S///'-ii./ Project Location: County ,he V /44�'r,
//� 15/,6 $ ha#ie y L ,9 N e Street Address/States Road/LotLo #(s) / -
40 �Mi.y yd� Sttate, ZIP 2509 V 5-4'�' .14,01 s�•i►� sle g,/!
( ) ✓---- Fax#( ) Subdivision �r
:ed Agent 4/, k. ` O,,a.- City 4/!//1/11/,j fr'7 ZIP 25 4
❑CW CV TA ❑ES ❑PTS Phone# ( ) '°"--- River Basin(,
❑OEA ❑HHF `IH ❑UBA ❑N/A D�,,��_4 ( / "
Adj.Wtr. Body /, ��C,� f� n /
❑PWS: ❑FC: /yes / re PNA yes /e0 Crit.Hab. yes / no Closest Maj.Wtr. Body o/'rl"#/%/� /,"
F Project/Activity .r ZP /7 II4, 6/s/ i/ ,'�/� ''
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,ck)length
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iier(s) �` .,/,-
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;ngth
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d/Riprap length ! i •
g distance offshore I - /� / 1
ix distance offshore
hannel _ - i
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bic yards rO ed
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np 13`x/.1 f/ie0 1 ,,440."
ise oath
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not sure yes .i- i
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;s: not sure yes oat
-ium: n/a yes ci
yes a , ;__
Attached: yes eP
Ing permit may be required by: 1/// G . See note on back regarding River Basin r

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COMPLETE THIS SECTION COMPLETE THIS SECTICI!ON DEL,VERY
te items 1,2,and 3.Also complete A. Signature ` ``
Restricted Delivery is desired. J 0 Agent,..... .DELUXE- NGU
ur name and address on the reverse X a.% _% �I'ti / . Adfressee
Ne can return the card to you. rip.b (Tinted Inv C. Date of Delivery ,,-
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his card to the back of the mailpiece, �` S� 7J<
e front if space permits. ti
D. Is delivery ad. •ss different fr.m item 1? 0 Yes A Q
dressed to: t if YES,enter delivery address below: 0 No • O�r
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3. Se 'ce Type O 4 g,c=n i) I
Certified Mail ❑ Express Mail O m?_ li
0 egistered ❑ Return Receipt for Merchandise LIl m ill
0 Insured Mail ❑ C.O.D. r o
4. Restricted Delivery?(Extra Fee) ❑ Yes m z
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umber n
7002 2410 0006 1882 2739
from service label)
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1811,August 2001 Domestic Return Receipt 2ACPRl-03-P-4081 O h. f N
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COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY 0 �, k\
te items 1,2,and 3.Also complete A. Signature
Restricted Delivery is desired. 0 Agent 0
Jr name and address on the reverse X V•__"_ 0 Addressee
ve can return the card to you. �� a�
pis card to the back of the mailpiece, B. Received by(Printed Name) C. Date of Delivery
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front if space permits. 3-i 7-03 r
dressed to: D. Is delivery address different from item 1? 0 Yes -0
aI uy^ if YES,enter deli .address below: 0 No lC -ttrit
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3. Service T er, /�/ m
Certified 0 i nc as au � Nlail
❑ Registered 4��❑ t�ff1 Receipt for Merchandise
0 Insured Mail 0 C.O.D. 1
4. Restricted Delivery?(Extra Fee) 0 Yes
tuber --.. 1.1
•om service labE 7002 1000 0005 6494 537'7 I
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1 1,August 2001 Domestic Return Receipt 2ACPRl-03-P-4081 (�q
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