39093D - Blades

LAMA/ D DREDGE & FILL
IENERAL PERMIT Previous permit#
New Modification Complete 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 I5A NCAC 9 '7 s aao
e ❑Rules attached./__
Name /3 7' ,O�4l S Project Location: County /t/f/'j' �Y�'HO!/lp'
Z//3 kv.A, /-10, /// . Street Address/State Road/Lot#(s)
1&,/e/6 Stateiv1' ZIP 2?-6,0e5 53 S .vlf,,,,` tj /5/0
(9/0) %1/3, //nG Fax#( //) Subdivision r�
;d Agent S � hi/2/L l7,f City ri.4 74i//r &Z . ZIP Z81/g
❑CW j 'EW ['PTA ❑ES ❑PTS Phone# ( ) 5 "Pi-r RiverBasin {-are
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body t19/�S C -" r"/f,/iat /n
❑PWS: ❑FC: A- /
res /� PNA yes / o' Crit.Hab. yes / no Closest Maj.Wtr. Body /`�� . l .,5:0, _
Project/Activity £'�h et e XcS 7s,, /js 'pi-E —/ Q
v� O X D ,
':% / le, sf/ e'ltii/'f . (Scale: / :
k)length
er(s) I i ' 1 i
igth +"
nber I _„_(1..�"L� _!
al i f
I/Riprap length // ,
distance offshore
(distance offshore ... ._
r- r
annel .�7 � I
sic yards f G �� i r
f ` f 1 4�`� '/
;e/:oathlft
,—.— i i
gx20 I -- -I
Length N7� 1 i
not sure yes ® 1 t
. not sure yes ® L_ -}- t.......4.. Filo — ' ..__ .. ......__ }— .......... —
um: n/a yes t _ — —......_pTT
yes ( ('12"r I 1/l ' fli�� II— .
// I I '
attached: yes �/ � i 'L: 1 I I � 1 � I i
ig permit may be required by: / /i CQ . H See note on back regarding River Basin rt.

lztlN 1 K.A.L 1' KIVll [ COYLY U TER FORM • 3
APPLICANT NAY::: &1y ,QaS
ADDITIONAL NAMES:
AEC DESIG: DEVELOP AREA , a.0 3 PROS DESC:
. (wal only take 6) ---- (Wal only takz i)
WORK: /S 8, 2D
(Ral o^ 4)
MAINT:
(WE oa:.y _4)
ilVE1): ("IV /6
�R71]oIIIY take 6)
�
'� ACTION EXPIRATION
1 J DREDGE& J REQUI i
-- s
CAMA MAJOR DEVEL REQU D:

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Lap
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Banks Channel
8 ft.
< >
0 0
A
*change*
6 ft. x 20 ft. floating dock T
to > p
8 ft. x 20 ft. floating dock m m
1
-01
0-
a�-s V
0
3
b
A
Deck
— X `.
•
00
co
scale: 1 tn. = 20 ft.
allowable sq./ft. for 72 linear ft. shoreline: 288 sq.i
sq./ft. used: 176 sq./ft.

COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
ratureig
te items 1,2,and 3.Also complete A. S �) ,gent =
f Restricted Deliverydre is desired. X ,(1 -ass /6,r a(,L ressee
ur name and address on the reverse ✓✓«I4.C.�`'`
we can return the card to you. B. Received by f Printed N e) C. Date of De very m
:his card to the back of the mailpiece, /f��!
5' /� 01025615545002
ie front if space permits. ? CI Yes D
D. Is delivery address different from item 1.
ddressed to: If YES,enter delivery address below: o ts-, o
ln1 D
Joliwrn/n A( t m
Loc, u-vocl aiesr
NC a75JJ o a
3. Service Type n
Certified Mail 0 Express Mail 1 Rl
❑ Registered 0 Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D. v
4. Restricted Delivery?(Extra Fee) 0 Yes t 4.
c i�
rurom 7003 1680 0002 5669 2250 E� o r from service la...- _
3811, February 2004 Domestic Return Receipt
102595-02-M-1540 0
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