39029D - Husselman

_i CAMA/ i DREDGE & FILL
ENERAL PERMIT Previous permit#
r�-'New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
orized by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to ISA NCAC 7 H/20-0
// ['Rules attached.
nt Name 7��(i # (el /tz( 5 se/pG/) Project Location: County B rzi r S /Ck.:
.s //y 6cr(c/(i) b ii re./Bo, Street Address/State Road/Lot#(s) //4
-! 1/-CO h State A/ ZIP . 4/42: ., /C.6--/F/ Gl J /Ye-e
# (`T'/O) 8HZ .25(o1 Fax#( ) Subdivision
ized Agent Grc. . Mr(cL City Her-Cd 5GaGh7 ZIP .tat/
d ii Cw ;Ow XPTA ❑ES ❑PTS Phone# ( ) River Basin 40
-
OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body Lia.r7 et- (nal
❑ PWS: ❑FC:
yes /® PNA yes / Crit.Hab. yes / no Closest Maj.Wtr. Body /wf'v
of Project/Activity L .
(Scale: /
(dock)len th ) x I 1
arm(s) b k y I- — �.._ i...._.. { .
Owl
r pier(s) i - .. ✓` i I
—�
n length 77 a �--
I I I —I I
i '
number i I
lead/Riprap length = �_.
avg distance offshore I I j I ' —_-_.
max distance offshore i !_.1.__ j . t t__.._ __.r ,
TF'
r,channel i } r
t
cubic yards , _ i .�...j i F _
I i !
ramp �......
house/Boatlift
i
h Bulldozing I i I I 1 1 I 1 2
: iH lot :
r I : i : : 4 — , �_
- 1
I i (
eline Length C�/ { • '
III
not sure yes G I ( i l r 01...•
bags: not sure yes 0 — _ _ .�- j I 4_4_-.._-..-...._
t....� {- — f i --.
rto
ttorium: n/a yes ....1 T _
os: yes 0 1 -
er Attached: (yes no ! C
ilding permit may be required by: 74keeie#1 6 .r(.] I See note on back regarding River Basi

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: I'�(d Hu55-e rnct. r�
ADDITIONAL NAMES:
AEC DESIG: G Lv pr- DEVELOP AREA: .O l PROJ DESC: P -l Z
(Will only take 6) 1 —— (Will only take 1)
WORK: P 2 12, (p
(Will only take 4)
10,20
MAINT:
(Will only take 4)
IMP: 3ZC
(will only take 6)
ACTION EXPIRATION
DREDGE &FILL REQUIRED: Of GS(o-f 46 3 loci
CAMA MAJOR DEVEL REQUIRED: �/U 3 / `4 I(1 G 3/0

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FROM• :JtPEACE ATTORNEY FAX ND. :336 475 7199 Jul. 29 2004 09:49AM �P2
Jul 28 04 12: 1Gp
Jul 2A 04 GBro4o Grog Holder
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