39000D - Grant

ICAMA/ '`I DREDGE & FILL
iEN ERAL PERMIT Previous permit#
New -Modification -Complete Reissue L7Partial 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 15A NCAC r H. /S- G
❑Rules attached.
t Name av ee►n 5 6r a n 4- Project Location: County Perld c'
q N. And e$.3 a n 13/./(i • Street Address/State Road/Lot#(s)
Osa :j 13ea11. State/\IC ZIP 2 '45 1 -6 N. 4 lid e, cnn gl✓0''
M) 32P-Oct' Fax#( ) Subdivision 6ueei5 Gr''etni
ed Agent 17 i )C Met(,'r1 City 770,5-01; / 1'Ca(A ZIP 2 ey /
❑CW )1CIEW ETA ❑ES ❑PTS Phone# ( ) River Basin Ceir e
[II OEA HHF ❑IH ❑UBA ❑N/A nn
❑PWS: ❑FC: Adj.Wtr. Body C Ara l (nat
yes / no PNA yes /K Crit. Hab. yes / no
Closest Maj.Wtr. Body -ref J41 i I -ram u PI fit
Project/Activity /i a ,rr-j C evpn c C d ear,r.•
(Scale: //'
:k)length
(s) $_ 1.0C /0i4GI,CL'E 0re� ! i 1 I rt -,-
y-.
11 i
er(s) ')s� 4� b, 4 ccrc5 r(/-)I' ■ {._
J I
Igth r 1... I �I ■
IiYV i
nber s�_
I/Riprap length i ... i 1 -,
}
distance offshore .1._.. i ) -f F ...._ —
K distance offshore ...... D jII_ ' . .i
ananner- 40r1-Z4' { 4 I
X Tofu, `r 1 • i
t'
is yards I ►�-f
ip i V
;e/Boatlift I PIMP' i
{ 1
I i �
NMI
illdozing j - ■IIIIMI
I
i I s
-lI Length _ ..._.._ _.� .........._ ;...-...�_ I _....-..-- '-- � �C-
� '� JI
not sure yes no ' � '
not sure yes no f Q to
urn: n/a yes no 1" _
yes no 1 i , FT_t ■
ttached: yes no i ' i I i i
ig permit may be required by: ,2S' ; i' (Sea C k . 0 See note on back regarding River Basin ru

GENERAL PERMIT COWL-TER FORM
M
V e e,,`S G✓�r l
isONpT NatvES• ���.�..� 0.(� 2., PROJ DISC: P -
Oa P�
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(Will only Tak 1)
p�SIG:
11\'•''_'01
rl:
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ACTION aATiON

ADJACENT PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to U/5r A T (- RI DJ 's
((Name Of Property owner)
property located at 9 i4' A).
(Lot, Block, Road, etc,)
on , in %0/254-1L hi" N.C.
They have described to me as shown below,the development they are proposing at that
location, and, I o objections to this pro osa ,
DESCRIPTI N AND/OR DRAWING OF PROPOSED
DEVELOPMENT
(To be filled in by individual proposing development)
(DA.32. 1<isc_, Lei4„_e_g
21d&A.
Si ture o Adjacent Owner
GEOP fE T.-MA-Tit/A)
' Print or
TypeName
<'916) 32, ? - 3 ,1/
Telenhnna

ADJACENT PROPERTY OWNER STATEMENT
mama„
I hereby certify that I ewe property adjacent to C L eeetS qra"."1" 's
(Name Of Property owner)
property located at 9 a it)• Poi
(Lot, Block, Road, etc,)
on c.in � �S4i �j-c.�P�. N.C.
They have described to me as shown below,the development they are proposing at that
'ocean, and , I hav, no objections to this proposal.
7 g : d2W-4/114447
DESCRIPTION AND/OR DRAWING OF PROPOSED
DEVELOPMENT
(To be filled in by individual proposing development)
1QA-Ccic.
64v1LAQ
Signs re o A jacent caner
,-.174U;i1 dys,/,‘,t)
Print or Tye Name
Teien}wnnn

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