41554D - VanVliet

l'CAMA/ ' .DREDGE & FILE!_ N? 4
3ENERAL PERMIT Previous permit# ; 7 5110.
'New JModification XCompiete Reissue __Partial Reissue Date previous permit issued
-ized 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 `//-1 - /2 c'Cj 7// //C,0
❑Rules attached.
t Name ,C/4c-f r J t 4-�/,),i i L , , (./i"P f Project Location: County Jr !'") t-c,i C..l-S
/ - 7 C / ' 4c../G .C<'r.7 -C c/ Street Address/State Road/Lot#(s) 2 7(r. /
, /e`(!/ State A/C ZIP 7 L Lt.)/ ( Cl cc( -f"
(i/<2) Y'/8-9 9i:5 Fax#( ) Subdivision Rtvelf. ide,
ed Agent !/�Yrl >c '
r)S !/e7'17c.2L. City ✓Gi,a FiCi v'�x -IZ ,.v'L._ ZIP .�')L-/C
CW C<EW IpTA AES ❑PTS Phone# ( ) River Basin LI r 7-
7.OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body La L(.,� / /-._U rl L/ nat
PWS: ❑FC: jJ _..
yes /'no PNA es no Crit. Hab. yes / no Closest Maj.Wtr. Body Z-'-'�k-/-`'�c-G`- Fr'//c /<
a _2 . .�
Project/Activity A 70 c .. / e.. ,,C_ it ' (�„„-/ - (e- f jc r/h/
(Scale: (/4-
:k)length /le' X er '
ti
(s) /zX/!o; zlr Frc 'rr� Z�$ eEJ ^/L�L7c:
tJ
ler(s) X /( --
igth . F.
nber —_ i �
i/Riprap length -/t
I-
distance offshore , i ,,r,.
(i, • t.G ,
x distance offshore '.rr t _ q
cannel �. T
,..
sic yards !_..... 4 ;
. .
,
, . ,
, ,
ip j
I 1 i
se/Boatlift a ti„/
illdozing __ L _ a i
Length /.3 r ,k. Xt5+ E3N� . __ _, ;�r_.s f ;_..j a�-5.c cf
not sure yes no , Ttc+ t r' 75'. , '5I PC
>: not sure yes no T,�GL/.�i . P,-_—.— �
cum: n/a yes no
yes no _i - 1._
7:5
attached:r-j;..i yes no i i 1
ig permit may be required by: / . ` See note on back regarding River Basin ri

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