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!"` CAMA AND DREDGE AND FILLS 0�►On74 _�
\ GENERAL`
(7-...._.) r
PERM I T
as authorized by the State of North Carolina
i�'��y/ Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC rJ l v
Applicant Name Jec 0t; cl(4 l) Phone Number@ )'Z rig_ G.s34
Address l a 0) 9 • Pit" — °l i • Q 5-1-•
City C9 r et i(71 r J State / V C d, Zip_/2�7 `) 6.
Project Location (County,State,Road,Water Body,Atc k" — U D.n e 41)4 'V v, 1 CO6 'r - DI-4 f
vA Location
Si 1— 6t+NL11 ai" /T/ & l / r� r1/4/Nile"�. � O.-YT
T of Proje Acti it C.on,�f..c-}" SD Ae. ..-5-1- 4� Ic4640 C IOK 5Ur Vt -Pc] byt ' -pod h'ile
fr,,- Q tiL, tci sur-49 q CKc�Vc-+-kt1 sJ ,—k-e,t,'/ �_r'p.,ik CIA cT'r ke
r?V e d /`n JJ.ce At 41.0 o P 4/ y 8'. A ..)1 c o h h . f 0 t 4 en4 c_ 4 e ct rJ'�. 1/0
4,?
9A,4 11 , ,D 14
PROJECT DESCRIPTION SKETCH WW „__ • (SCALEa/x-r - SC je )
Pier(dock) length ( it
ISo see f f i '1
Groin length a ikiLlit f ( (,/
fie ti
number /1�
Bulkhead length b�
I rktc',., 'c ^max.distance offshore �rJPoSt�
Al I kite.(,)
Basin,channel dimensions /7 A M(.�
cubic yards 5-, 14.1 '..-..- gii
y
I, ,
5l "'
Boat ramp dimensions .ce Ck-
M
Other i
dy
V, 501 a '
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Anyi. / ..
violation of these terms may subject the permittee to a fine,
applicant's signature
imprisonment or civil action; and may cause the permit to be-
come null and void.
This permit must be on the project site and accessible to the
1 permit officer's signature
permit officer when the project is inspected for compliance. l 3 D /1 6 - o --u(Li
The applicant certifies by signing this permit that 1) this pro-
ject is consistent with the local land use plan and all local issuing date expiration date
ordinances, and 2) a written statement has been obtained from /�'
I .
adjacent riparian landowners certifying that they have no J
r7� //D �- so r ve 1
objections to the proposed work. attachments j
GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: /,`) & o ar
�t. g
ADDITIONAL NAMES:
AEC DESIG: PT,, ,S ELS ( DEVELOP AREA: _.0 JROJ DESC:P AL}
}
(Will only take 6)
(Will only take 1)
WORK:2j-1-1 � ("I'd
(Will only take 4)
MAINT:
(Will only take 4)
IMP: d� t) TOO
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: (19)-` - Q q
CAMA MAJOR DEVEL REQUIRED:
'd SENDER: I also wish to receive the
D •Complete items 1 and/or 2 for additional services. following services(for an
rn. •Complete•items 3,4a,and 4b.
a) •Print your name and address on the reverse of this form so that we can return this extra fee):
card to you.
> ■Attach this form to the front of the mailpiece,or on the back if space does not 1.❑ Addressee's Address
d ■Write permit."Return Receipt Requested"on the mailpiece below the article number. 2.❑ Restricted Delivery i
YConsultpostmaster fee.•The Return Receipt will show to whom the article was delivered and the date for f '
delivered. 1
0 3.Article Addressed to: 4a.Article Number li
o
a
20. ' C—:� G w`N �- 1 L 4b. Service Type i
0 1 ❑ Registered Certified i
x p t(
• e,ri ✓� g 2_ El Express Mail El Insured
L 1 ` ❑ Return Receipt for Merchandise ID COD
r;Y--1 r V' �V 1 f 7. Date of Delivery
a
Z 7 O zj 5- a. 'aV- ' '
.� E-Received By: (Print Name) 8.Addressee's Address(Only if requested
?� and fee is paid)
w 6.Sign re: ( ddress e o Agent)
o -• X - -2-67--,.--------
PS Form 1, December 94 1) 102595-9e-13-0229 Domestic Return Receipt
i; SENDER: I also wish to receive the
2 •Complete items 1 and/or 2 for additional services. following services(for an
n ■Complete items 3,4a,and 4b.
L •Print your name and address on the reverse of this form so that we can return this extra fee):
gcard to you.
■Attach this form to the front of the mailpiece,or on the back if space does not 1.❑ Addressee's Address
y permit. l
•Write"Return Receipt Requested"on the mailpiece below the article number. 2.❑ Restricted Delivery i
. •The Return Receipt will show to whom the article was delivered and the date
delivered. Consult postmaster for fee.
0 3.Articl&Addressed to: 4a.Article Number 1
o
o ED GOB yp
4b.Service T e
E ❑ Registered ElCertified
' "t��t ��� ❑ Express Mail ❑ Insured
u *2-b' El Return Receipt for Merchandise ❑ COD '
n 7. Date of Delivery
r .5.'Received By: (Print Name) 8.Addressee's Address (Only if requested
_D and fee is paid)
L 1
r 6.Signatyr%(Addressee or nt)
6.
a PS Form 3811,December 1994 102595-98-B-0229 Domestic Return Receipt