41593D - Ward

6AMA/ ❑DREDGE & FILL ,f'J' L 1
;ENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue Partial Reissu Date previous permit issued
ized by the State of North Carolina, Department of Environment and Na Resources
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC '7i/, /30()
Iii.Kules attached.
t Name Ky Iv W ia-Rt) Project Location: County UANsW iCK
0 6 v bA 0-ks,1J4, 01%" IJQ / s'/r! /05 Street Address/State Road/Lot#(s) L,'t 6 S'
A Rj( State A/C ZIP _)?S/3 _.1-�4,eLI,c IRp S f //7 so a...,,
(9, ) `/(7a-O,75 Fax#( ) Subdivision
ed Agent 4/4 City Q'C,5A#- .T�/E /t ZIP a ej/
p.rW „ A ❑I ES ❑PTS Phone# ( ) River Basin LtAYv.
E OEA ❑HHF ❑IH —UBA ❑N/A Adj.Wtr.
❑ PWS: ❑FC: Body �AmF CRC ..._ (nat /r
yes / i PNA yes /) Crit.Hab. yes / no Closest Maj.Wtr. Body ��V../
Project/Activity PIQ(UAfr P'4F R 4 1Y0 LK.
\ \// (Scale:l -- .2
:k)length 5 I)( l/c t I Qeo) S� ti . �.-_. 1�+� .. /�1 —
(s) 8'r1C/`/
1 �,rr —
/5 , i
er(s) rA IN t
h f, ry� 5¢t
gt :tnber4.I/Riprap lengthrs,
distance offshore
x distance offshore `
annel � 1 f
iic yards --^" (!� �v.o,�-F
-I Boatlift re t'
lldozing ,- / .A -
JG v J E
+ o0«. _ / r
/
Length r' _ ` ` F .
Ci 9
not sure yes
not sure yes es7 1 r '': e1 N4.r 1
um: n/a yes 69)
yes Cc - t ,_.-
ttached: yes no
-g permit may be required by:i See note on back regarding River Basin ri

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R: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
Clete items 1,2,and 3.Also complete A. Sig ..,
4,
4 if Restricted Delivery is desired. i' Agent
your name and address on the reverse X • • An Addressee
at we can return the card to you. B. Received by(Printed Name) C. Date of Del([//ivery
h this card to the back of the mailpiece, 0
the front if space permits.
D. Is delivery address different from ite 1? ❑Yes
Addressed to: If YES,enter delivery address below: ❑ No
0.0()Ale C_. Rtke_hla
15 14111+4) Dr
S&k NC. �,2110 6 _
ash, / 3. Service Type i e DELUXE WALLET on wnK.TE SAFETY PAPEF
®Certified Mail CI Express Mail ■ a a
CIRegistered CIReturn Receipt for Merchandise 0 p ■ z y
CI Insured Mail El C.O.D. '', ino O
4. Restricted Delivery?(Extra Fee) CI Yes r ? /11 m
7004 0750 0000 5195 7509 O ` �
Number •
fer from serk r W 5 I.. k
'4r Lr1 ( :. nC
`13811, February 2004 Domestic Return Receipt 102595-02-M-1540 CO s in (A.1
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r A Z f
ry — •
COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY Lll C n
ete items 1,2,and 3.Also complete A. Signatur ru 0 c
if Restricted Delivery is desired. M� / ❑Agent 0
our name and address on the reverse X I C � ❑Addressee O
t we can return the card to you. B. bed by(Prin d Name) C. Date of Delivery i '—
this card to the back of the mailpiece,
he front if space permits. p Jj a1 �i'� Li ,'
Is delivery addr ss different from m 1? ❑ Yes r
I
>ddressed to: If YES,enter delivery address • ❑ No� Gow '"ray j !`l..irQl o8.5, r
t-
; h r N.0 ;2-?10OY 3. ' eType __so"
1i ,rtifled Mail ElExpress Mail
ID Registered CI Return Receipt for Merchandise
n, '.Ch Cv\\ s i ❑ Insured Mail CIC.O.D. '
I
4. Restricted Delivery?(Extra Fee) ❑Yes C
O
dumber 7004 0750 0000 5195 7516 , a o
r from sen
g XJ N D
3811,February 2004 Domestic Return Receipt 102595-02-M-1540 •
• % fir. ' _.