42027D - Van Arsdale

CAIVIA/ VDREDGE & FILL Ne1.9 4
GENERAL PERMIT to Previous permit#
New i Modification Complete Reissue Partial Reissue Date previous permit issued
ized by the State of North Carolina,Department of Environment and Natural Resources 11D
0:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC H
A,❑Rules attached.
:Name TQN"+ /Vi r,s%%/ Project Location: County /t"sb' /jl.4 /
952Q 2 /a!!/ /4,,�e, Zn' . Street Address/State Road/Lot#(s)
v//ri»%)1717`7 State4K ZIP2 '9// g5o90 Se; // 4- /_7 .
(90) 5.G .�J22 Fax#( ) ..--- .r
Subdivision
ad Agent t J/4-P/�y/ �/'7 City v(//4 1/5 4h ZIP 28'
CW ❑EW ❑/PTA Lies" S Phone# ( ) 54440 River Basin '/C21
OEA E HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body af, (nat et
PWS: ❑FC: / 5��
Ott
Y3I/ no PNA de / no Crit.Hab. yes / no Closest Maj.Wtr. Body / /<
Project/Activity 7ii�S 4 lit Q'r1 e-h� �ir�4i4' ; /per '/
41
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:k)length
er(s) X ,,,
igth44 _
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nber
r //LPL fXi'3 �"`f /
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I/Riprap length h t/
distance offshore 0 i lJ�
x distance offshore a ,A,
SSS� I Yt
annel I' ek ,G f
v.r
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iic yards j
se/Boatlift 0 e' i r;/t , i
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slldozing / Q !if/r�/h /1 V i 1 6if %'
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s Length /Pe t
not sure yes � �.. _
s: not sure yes a ,. _ (r— -��„�
,um: n/a yes & f,, /-m (_ } ' ` , t V
if no
attached: yes `v� -_f�FtiltA1/r/7i le
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i ,tg permit may be required by: Cep • . I See note on back regarding River Basin 11

JUN.14.2005 2:42PM B PARKE 7.sl• NO.139 P.1/2
i"1 J i ribly I4ur•Lh — CMC FA'A NO. : 912256639'7 Jun. 02 20E6 05I 19PM P2
&D.L.1 i.,c,ti.f,. j,' �Li��.� .i��2! 11� . . i‘ `.4.1 ) 14L,1.L A4.J.0 1'N.VVI'k EC) t
tNum Cr!Inctivicii.W App4014 F2r POnna.: 4,5 o. L7 A 4 (iv
Addnu or Prar.rry.
(la emnot int*or -Wdi City is County)
Dr,by tardily that I own gamily ad uani for ab*ve-rafersaaed prcparty. The badividua(
� � f emit t d. -tbut w ed I own on CIS drawiai for aaw1opaiii7t
proposing. A dasariptIon or tlaswij, wisia disosoalfaa, should he providrd with dab
I Ws aao objactlaa: to this p?apaI1.
UM-We AbiletifrtIo 1164..ii id ^Iatili L w'It i the nmairrr, fAteramai
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T itisdl wrf ow •Pia., i.aia, 1144614eisi rniRy1 l.+.rt1►wsM+ 1.111.4 i WI& li t•or saapagi must be
aat hadr a .ni�ta2uss Of W ��a la aar�. ivi Jai Wad.r.,f r4p rut imager nw)ua s a y rMa. of y....
w we;vo tiro u�`yoU alttltt she hurt bIM ham)
1 . b I d wlrk to Wino the is' setback requirement.
I d4.0 wish to slilvs thw id' setback requirement
A• O,, .,t..__ 'j 0
iffISSISt k� -het`
4 Pr t Nan,. -
tsuibu1Lh Arm Co

JUN.14.2005 2:39PM B PARKE N0,138 P.2/2
M : Jimmy North - ctic FAx NO. : 9102566357 Jun, 02 2005 05:19PM P1
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DATE (0/ /6/05 BRA
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® WACHOVIA
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