39062D - Egland

]CAMA/ ❑DREDGE & FILL:
3ENERAL 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 ���(/
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:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 714.
/ NI.Rules attached.
t Name GP/4 A/( /0, El /4/1/ Project Location: County 7, — -6 attached. .4
i") 51104 /3o0n.+y Lei Street Address/State Road/Lot#(s)
ey 14/10 State FL ZIP 31637 ? (7ri A e /4.
`(3055152—WI Fax#( ) Subdivision
:ed Agent A t kQ RI City /fr Al SfiPd ZIP 7 ' '
CW L'k,IEW XPTA :WS ❑PTS Phone# ( ) - River Basin AOI
OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body ,.47h(I4) (nat 4
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yes / no PNA yes / no Grit.Hab. yes / no Closest Maj.Wtr. Body
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U.S. Postal Service,.,
m CERTIFIED MAIL., RECEIPT
Q' (Domestic Mail Only;No Insurance Coverage Provided)
For delivery informationmac visitisit our website at www.usps.com:,
ru °•_. LE tkA N/ 0 U S E -
m Postage OMNI
D Certified Fee $2.30 0443 I r W o,Z
0 44 m x ...to_ Postmark ❑ _
p Retum Reciept Fee $0 00 Here
(Endorsement Required)111
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Restricted Delivery Fee $(! QC1 O ^\\ N m ,
1-11 (Endorsement Required) ❑ a
$z.67O � v
. m Total Postage&Fees $ 08/20/2004 ❑
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Street No.; F.
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City,State,ZI► goof sTe 4 A iA C 2 9- Ni
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PS Form 3800.June 2002 See Reverse tor Instructions W
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Mike Klettner
.. Unlimited Builder
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M. Klettner Construction •
1351 Washington Acres Road b4
Hampstead,NC 28443 17 c 1
[phone] Cw
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