37962D - Fussell

]CAMA/ J DREDGE & FILL
3ENERAL PERMIT Previous permit#
-iNew -Modification `Complete Reissue iiPartial Reissue Date previous permit issued
rized 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 7 H . 12.00
ElRules attached.
t Name LJ ;III G M t RI SS e�I Project Location: County P hd t
P 0 eOX 2.2 3 4 Street Address/State Road/Lot#(s)
v i r ( ,+ j state14 C Zip 26`-4S 9jj 6) '741-, _s-4
0)32c. -320S Fax#( ) Subdivision
:ed Agent City _11 'l C + ZIP 2 8 u 4
ii cw %EW PTA ❑ES ❑PTS Phone# ( l B ) 2 8- 3 2.05 River Basin Cc.r c
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
❑ PWS: ❑FC: Adj.Wtr. Body Cafr-‘a I (nat A
yes / no PNA yes /V Crit. Hab. yes / no Closest Maj.Wtr. Body ' w
fProject/Activity New ;r.5c,• e;e✓ r a✓ c( 6oa4 111'4 ✓tex ) cx,r1;�J
1,"-�.ro r►+1 (Scale:/I r= .
ck)length 3" X 2 0
,ier(s) 3 k 0 �\ rT - y
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,ngth
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mber I
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d/Riprap length ._.; —._ 3'X 2v► r l—if i
g distance offshore ii
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ix distance offshore r — . ;...... ..._. ` ! +. i ...... . +
iannel { I f
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is Boatlifs>ii I k i ... _ • __T... ' 'X ' s A ,q✓
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e Length
not sure yes ho n 1 i
y
s: not sure yes no I _
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lum: n/a yes no 1.... ,�
yes no y `IX/ ��}.!`. /� t/ f� I '
Attached: yes no i
ing permit may be required by: .c r 4 C +-I . ❑See note on back regarding River Basin r

371G
GENERAL T CON' PTJ ER FORM
DDITiON.=T NAMES:
C DESIG: D V OP nr..;:_CL�L L PROJ DESC: L '2..
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WORK: PR 10 x3 ib LAX-�—_- •
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ACTION aATION
DREDGE E&FLU,REQUIRED:
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