37899D - Miller

:CAMA/ DREDGE & FILL
jENERAL PERMIT Previous permit#
New 7-Modification 'Complete Reissue CPartial Reissue Date previous permit issued
sized by the State of North Carolina,Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 7 H • 2 000
,Lfkules attached.
t Name Bee 4nkci ► i + Ile,r Project Location: County 0h c 1 °LJ
PO 130)c- It) 1 Street Address/State Road/Lot#(s)
OntsettAd State iN C zip2R3 98 el o S 7 9-NA A S-I
(41'1O) 2?I-0080 Fax# ( ) Subdivision
ed Agent City Cu r F G ' zip 2 g 4 4
cw EW PTA ❑ES E PTS Phone# (4 16)Z')I—h o 86 River Basin Cap E
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❑ PWS: ❑FC:
yes (no PNA yes / no ; Crit.Hab. yes / no Closest Maj.Wtr. Body A=t^)w
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ng permit may be required by: -‹-L,r-` C i.4 7 . I See note on back regarding River Basin r

3 ,
GENERAL PERMIT CO U I ER FORM
A'PL IC_-N 1 N.ME:
DDIII ON.=T N A)vES:
A
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(Cvi I only ra c 3)
(Will only calm i)
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• AL lION ETTZkTION
DREDGE E&FILL R�QLiR :
CAMA MAJOR DEVEL REQUIRED:
1 \

ar, 25 04 10: 29a Wayne Hair (9101 424-8605 p. 1
Mar 25 04 08:36a p. 2
March 25, 2004
I agree to allow Bertha and Marshall Miller to put a Boat
Lift with or without a cover. I waive the I5ft set back if
required. My property is located to next to 9057 9`h Street
in Surf City, NC
Tommy Black
Signature 4getj / 3/25/°

March 26, 2004
I agree to give Marshall and Bertha Miller to put a Boat lift in with or without a cover. I
waive the 15Ctet back if required. My property is located next to 9057 9`h Street in Surf
City, NC
Rebecca Brown
4.die,
Signature '/
Date 3_ 0(.0 oI
AlOt To e ,r e-ee 2 alp o ea-yo-e

%1AIMIIMEMEallailikairr/:q"_i_.- ier i -
,: BERTHA TAYLOR-MILLER NCDL 1154e93
1, MARSHALL B.MILLER NCDL 3762071 7938
� PO BOX 197EGE ST PH 910-293-4558
WARSAW,NC 28398 "2� - e8 7704/2531
n
a p 7 DE/ DATE
PAY TO THE
ORD F I $ /00 '—
d dil?eele o !
� O6L'CAR5 B Or
State Employees'Credit Union %
S_ 1$enanavtllq North Carolina
1111111.
FORjae/tAt,e73' /y 410 1./Z ."
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