51036_NC DOT_20080415

/S6
❑CAMAWD DRIEDGE & FILL
GENERAL PERMIT Previous permit #
[-]New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name
Address
City State ZIP
Phone # ( ) Fax # ( )
Authorized Agent
❑ CW ETEW ❑ PTA
Affected
❑ OEA ❑ HHF ❑ IH
AEC(s):
❑ PWS: ❑ FO
ORW:
yes / no PNA yes / no
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity -
(Scale: )
Pier (dock) length
I i I
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other '
i
I
i
�
4
I
'
I I
Shoreline Length
SAV: not sure yes no
I
Sandbags: not sure yes no -
Moratorium: n/a yes no
Photos: yes no _
Waiver Attached: yes no
A building permit may be required by: ' r 'See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Permit Officer's Signature
Issuing Date Expiration Date
Application Fee(s)
Check #
Local Planning Jurisdiction
Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

F--?6ANIA / C DREDGE & FILL
N? 51036
GENERAL PERMIT
Previous permit # "
F—'—Tw ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources O C
and the Coastal Resources Commission in an area of environmental concern pursuant
to 15A NCAC
Applicant Name N
'—' ules attached.
Project Location: County
Address / l0X
Street Address/ State Road/ Lot #(s)
City GTc CnV/ State �. ZIP
�-31
Phone # ( �30 ���o Fax # (}
Subdivision
Authorized Agent J�Ay Tv�nran
Cityti Al C ZIP a--,F-1.r4
[ICw IOW CYPTA [5tS ❑ PTS
Phone # ( ) River Basin
Affected
AEC(s): ❑ OEA ❑ HHF ❑ IH ElElUBA N/A
p G ��
Adj. Wtr. Body r r z (JG� /man /unkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes no Crit.Hab. yes / no
^•
Closest Maj. Wtr. Body
Type of Project/ Activity a1-f �f `^ ` / W o V x 6 r r x 6 L r c- l veltr --/z r c plw c�
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length '-
number
Bulkhead/ Riprap length '
avg distance offshore
max distance offshore
Basin, channel ,
cubic yards
Boat ramp
Boathouse/ Boatlift j
Beach Bulldozing '
Other (V,,a Cr,� I v 4 t)) qJ
r
Shoreline Length Iva
SAV: not sure yes
no
Sandbags: not sure yes
Moratorium: n/a ©e
no
Photos:
no
Waiver Attached: yes
no
-tL,Vr� r7 ` X 4 :?" X G C` c, It,
(Scale: pi/ � )
r—
__
J 1
--
!� 6-T'jC,� o'
- -
r -
-�-
---
I771
i
,'—
!
—
_
t—
;
—�
I'
L
j
i
r
-
A building permit may be required by: `j►y' I c ` "'" I� see note on back regarding River Basin rules.
Notes/ Special Conditions "' j✓l
�ryl�f� %%r�•/. l�J (u/%iar�y Lo4ll j %l,a1I VJJ r 1i'
Agent or Applicant Printed Name Permit0 cer's Signature 1
Signatur ** Please read compliance statement on back of permit **
00
Application Fee(s) Check #
Issuing Date L Expiration Date
(A jd C CU � 4� nT'� x o,:�-o-"o,'
Local Planning jurisdiction Rover File Name

��
����
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director 1Nilliam G. Ross Jr., Secretary
April 15, 2008
NC DOT
Jay Johnson
PO Box 1587
Greenville, NC 27835
Dear Jay Johnson:
Attached is General Permit #51036C to Construct (2) 95"x6T'x60' culverts to replace two
8T'x63"x60' culverts at SR1321, approx 125' east of SR1329, Merritt, NC
In order to validate this permit, please sign the permit as indicated. Retain the white copy for
your files and return the signed yellow and pink copies to us in the enclosed, self-addressed
envelope. If the signed permit copies are not returned to this office before the initiation of
development, you will be working without authorization and will be subject to a Notice of
Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely,
Stephen Lane
Coastal Management Representative
lsb
Enclosures
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.necoastaimanagement.net
An Equal Opportunity 1 Affirmative Action Employer— 0% Recvcled I f 0% Post Consumer Paper

RCM MP -A
F
9 a
APPUt. -TIONfer
PIE
majeflevelopmentf�ir mi MAR d 9 ?�[��
pasta:revised 4. 2i27106}
tork4;i Cairo�ii froj �NAGEMENT
I. Primary Applicant( Landowner:/nfoxmatidn
Business Naive,
Pro)eo# Name"(if eppligable)
Notth CarofinacDepartment Of Transportation
NI-27 Pipe Replacements, SR 1321 over Brown Creek
Applicant l ::First Nace
tillI
Gast Name
Jay
B.
Johnson
A0011cant'2: Hirst Name
MI
last Name
!f additional applicants . please atfach an additional page(s) with names listed;
Mailing Address
P.O BoX
Gity
State
1587
Gfeenvilie
NC
ZIP
cour►try
Phone No.
FAX No.
.2.7835 1587
US
252:- 830 - 3490 ext. 248
252.830.- 3841
street Address, (if di"ntk6m above)
City
State
Zip
Email
jbjoh nson@.tot. nc.state.vs
2. Agent/Contractor h7formation
Business Name
Agehtf Contractor 1: First Name
IVtI
Last Name
Agenti. contractor 2: F:irst Name
MI
e.
s.
Walling Address
PQ Box
City
State
ZIP
Phone No. 1
Phone No. 2:
ext.
FAX No,
Contractor #
Street Address cif different from above)
City
State
ZIP
£rr►siii
<Folrm continues on back>

Form DCIVI MPA (Page 2 of 5) fa►r
,. ® � ; � APPLILATIQN foi-
Major Develo.pr7iertt Penrrit
M P.
3 Project Location
County (can bo.. Multiple}
Street Address
�� �Wt
State Rd:.#
'Pamlico
SR 1321
Subdniision Name
city'
State
Zip
Phone No.
Lot s No. . (Ifmany,.
( ). ( rry;; attach additional pagewffh list)
a.. In: which NC:Oerbasin is the projeot'looated?
b. Name.of body of Water: nearest to proposed proje ct
Neuse
Brown Creek
c. Is the water body identified.in (b) above, natural or :man.MatSe?
d. Name the closestmajor water body to the proposed project site:,
[3N:atural. []Manmade ❑Unknown
Broad Creek
e. Is proposed work within city litriite or ptartrnnj jurisdiction?
f. If applicable, Hst the planning jurisdiction or citylirrilt the proposed
[]yes ONO
work falls within_
4. Site. Description
a. Total 16.0.gth.of shoreline on thete*t (ft.)
b. Size of entire tract (sq.ft.)
$'
NA
c. Size of individual lot(s) :
d. Approximate elevation of tract above NHFN (namialHigh water) or
NW L (normal water leveg
i
(Ifmatty totsizes; ptease attach addi ional page with a fist)
215' [}NHW or ®NWL
a. Vegetation on tract
Panicurn species
f. Man-made features and uses now on tract
Road
g: Identify and describe the existing land uses adiacent to the proposed project site.
Marsh end Woods.
h. How does local government zonethe tract?
is Is the proposed project consistent with the applicable zoning?
NIA
(Attach zoning compliance certificate, if applicable)
❑Yes ❑No GINA
j; Is'thepropasedactivitypartof:an_urbah:waterf>orttr®steveiaprrfent:proposal?: ❑Yes No
k. Has:a professional arch aeological:assessment been.doneforthetract? :If yes, attach a copy. ❑Yes ❑No ❑NA
ff yes;. by whorl?
I. lsthe proposed' project oeated in a National Registered Historic District or does it involve a ❑Yes ®No DNA
National R.egisterlieted'or eligible property?
<Forrn confinues on nett page>
m. (I) Are there:wetlands on the site? Yes No
(h).Afe there coastal wetlands:on.the site?: ❑Yes ONo
(di) If yes to either (1) or(ii) above, has,a delineation been conducted? ❑Yes (QNo
(Attach documentatfon; if available)

Form OWMIP-1 (Page 2 of 5)
... — . . i . . ... . ..
APPLICATIONI& Development P 6ftnit
3. Pr6 ]6ct Location
county ,(can oerqu ple)
Pamlico.
Street Address s
Morehead City
Stale Rd;
IXW�J
Subdivision Name
state
(P
Phone No.
Lot No.(s). (if many., aftach addidonal page.with list)
od.
a, In:wtitch N.riyer basin is the 1proje located?
b. Narne of body of Water. nearest. to pr6posed Project
NeUte
Brown :Creek
c.: Is the waterbody identified1h (b) 66v4,'66tural or manmade?
d. Name the cimst. major waterbodj to the Proposed project site...
ONatural. E]Mahmde OUnknown
:Broad Creek
e. Is proposed work within city liMita:or.pla6ninojurisdiction?
f. If applicable, fistthe pla.n.ni the proposed
ng Jun I q
[]Yes E . )No,
work4alls within.
4. Site Description
a.. Total IeNth.of shoWthe onthetract 00
b. Size of. entire. tract (Sq ft)
80,
N/A
c. Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high: water): of
NWL (normal waterlevel)
(if m8hlot stzeso p1dase:a(tach a0ditional page with a ffst)
2.5' ONHW:or EINWIL
6, Vegetation on tract+'
Panicum Spqcies
Manm.rnade:features and uses now ontract
Road
g. ldentify:and describe the existing land uses :adiacen to the proposed project site.
Mafsh arid.Woods
h. How does local: government zone the tract?
is Is the proposed project consistent with the applicable zoning?
N/A
(Attach: zoning compliance certificate, if applicabld)
Oyes O'No ONA
dactivi parto.f.an E]Yes E No
Is proposety .urban waterfront1ed6veloprtlent ptoposal?.�
k. Hasa professional archaeological assessment teen &i;-'G:tha tract? :If yes attach a copy. C)Yes No UNA
if yes,. by Who r
I. Is the proposed proiect lboated in a:National Registered Historic.District ordoes E]Yes ZNo DNA
. ... ... . oe.s it involve a
.National Register listed or efigible property?
<Form continues on next'p4ge>
M. .(1) Are theeemet.lands on the. site?
#11) Are (hpre:coa$tal W.eflqln0s, on the site?
(iii) if yes to either (t)'qr (ii) above,,. has. -a delineation been conducted?
(Attac.h. d9dumentatfon, if available)
!Zmbkfl�
DYes ONo,
OYes DNo

Form:DCM MPA j.Page 3 of 5) APPLICATION for
MAR 1 Major Development Permit
20i
n. Describe: existing wastewatertreatment facilities
N/A:
Morehead City
o. Describe existing drinking.watersupplysource.
N/A
............... .
p: Describe existing storm water management or treatment systems:
N/A
S.. Activities andlmpact's
a. Will the project be for commercial, ublic, or. vate use's p J p pri DCommerciaf )�Pubhc(Government
D P r i v a t elG o m rrmu nity
b Give: a brief, description of purpose, use, and daily operations.of the project: When complete.
The Existing. Two 87"x63" 40' Will. Be Replaced By Two 951'x67"x 6U.Pipes. These Proposed: Pipes Will Keep The
Roadway Froili:Colla.psing,: Thus. Preventing Possible: Injury and Death.
.. ....
c. Describe the proposedi:construction:methodology Vpes of construction equipment to be used, during construction, the number of each type
of eQUfpmerltand where It Is to be stored.
The Existing:'Pipes Will Be Removed and the Proposed. Pipes Will Be Installed. Typical I.Roadway Construction Equipment
Will Be Used: Itlt=j.... 91But NotLi.m edTo Tracked. Excavators,DumpTrucks, Flat -Bed: Boom
Tucks.
d; List all development activities you propose:
Pipe Replacernent and.Asphalt Patching
......
e. Are the proposed activities maintenance of an existingproject, new worki. or both? Both
f. What:is the approximate total disturbed land area resulting.from the proposed.project? 1460 SSq.Ft or ElAcres
g. VVIII;the proposed project encroach on'any .public easement, public. accessway: or other area ❑Yes []No ENA
thatthe public. has. established use:of?
h. Describe locatiori.andtype of:existing and .proposed :discharges to waters of the -state.
NIA
i. Will wastewater or stormwaterbe discharged into a wetland? Yes ®Na E] NA
If yes, will this discharged water be of the same salinity as the receiving water? []Yes E]Na. ❑NA
1. is theft anymitagation proposed? OYes ZNo ❑NA
If yes; attach a mitigatlon:proposal,.
<Form :continues on back?
6. Additional Information
In addition to this completed application form, .(MP.-1) the following itenmsbelow, if applicable, must be submitted in order for the applica don
to be complete., Items a package p () — (t) are alwaysapplicatiie:to any tnaior development application. Please consult the applkaflon
instruction booklet on how to properly prepare the .requ{red items.below.
a. A project narratim
b. An accurate, datedwork plat (Including plan view. and cross -sectional drawings) drawn to scale. Please give the present statas,of the
proposed project, is anyportlon already complete?. If. previously authorized: Work, clearly indieate.on maps; plats, drawings to distinguish
between work complefed:and proposed.
c: A site :or location map that is sufficfently detalled`to guide agency personnel unfamiliar with the area to the site.

Form :.DtM'MP-1 (Page 3 of 5)
APPLICATION for
Major Development Permit
ii, De.scribe.eMsting wastewater.treatment f6dilitles.: V1 11K'AV
N/A
MAR 1 9 N08
. . .. ........ ..
-0. Rescribe existing. drinkingwateraipply soUtce.
N/A ... Morisheau City PCM
0: Describe existing storm water managernent iorAfeatment systems,
WA
S...Activities and Impacts
a. Will the project be for commercial, public, orprivate use? E]Oommemial 0661008vernment
Ejpriyotelcomrrwnfty
-b- Give a brief description of purpose, use, and daily operations: of the project When complete.
The existirig.Two 8TW3" x6.0'Will. Be Replaced By Two 95"X67NBU.Pipes. These Proplosed.Pil)es Vvill Keep The
koadway.Frohi.Collapsihg, Thus. Preventing Possible Injury and Death,
6., D6scribe the proposedconstruction methodology,- types pf:cOnstruCti0h OQUIDnienifto be, used during cons ruct on, the number of each
type
of eq:6ip:rne::nt_and'. Vhere it is to be stored.
The Existing PipesWill Be Removed and the Proposed Pipes.Will Be Installed. Tyric,81 Roadway Constr=tion Equipment
Will 86 Used *')b ing But Not Limited To Tracked'Excavators Dump: Trucks, Flat -*Bed Trucksk_H :8acoes,And.Bo'oM'
Tr4.0s-.
d. List all �developmehtactivities you propose.
Pipe Roplarement andAsphalt Patching
:e. Are the proposed activities maintenance of an existing project, new work,. or both? Both
t What is approximate total .disturbed: ]Ond area riesulting.from the proposed project? 1:46U OSI.Ft or []Acres
.q.. Will; the proposed project encroach on any pu bfic easement public. accessway or othe r area Yes DNo, [DNA
thatIthe pubtic.has.established use:of?
h. Describe locat on...and type o.f:e),d*ing and .pro ed discharno-s to waters of the state.
N/A
i. Will wastewater or stomwater be discharged into a wetland? ElYes NNo, DNA
If Yet; Will this s discharged waterbi6 of the same salinity as the receiving water? OYes ClNo EINA
i. Is th6r4p any mitigation proposed? . ....... OYes ZNo [JRA
If yes; attach a mitigatior.) pro po sal,,
<Form continues on backer
6. Additional Information
In addition to this completed appricationform,,(MP-1) the following items, below, if applicable, must -be, submitted in orderforthe application
package to be complete. Items (&�— (Oare always app#cabl6:t6any mqjb . r development applicatfon,' P16a:se consult the application
instruction booklet how to propiefly prepare the requiredOmsbalow. a. A project'harmfive.
b. An accurate, dated work plat (including plan view and cross -sectional drawings) drawn to scale. Please give the present.statusof the
proposed project, IsAny,portlon already complete? If pre.viously authori2ed Work, clearly indicate on maps, plats, drawings to distinguish
.between work completed and .proposed.
c; A sitebr:ftafion map that is suffid6ritly detailed to g uide agency personnel unfamiliar with the area to the site.

k ' Form. DCM MP-1 (PageA of 5)
grcd
".0 APPLIGAIION for
Major DevelopmohOernnift
MAR 1 19 /'; ,
'-'d..'A copybf the,deed (with state application only) brother instrument under which the ff e o ertles.
,ppIJ[cant claims title to he M
a fhe ppropqateappljcaieck. or mon Ion fee. th. ey iordermade payable to DENR:-
f.. A list of the names and complete addresses of the adjacent.w,aterfront (riparian), landown.ers:and signed return receipts as proof that such
owners have received a copy of the application and plats by:c.ertifted mail.. Sudh landowners must be advised that they have- 30 days in
which tosubmit comments: on the pr000sedprojed:to the Division of Coastal Management:
Name Afton. R. Woodard
Phone No.
Address 719 Clerraprit Road,NeW Bern, NC .2$56.0
Name Haywood. ?QrXM9n
Phone No.
Addrets9W8.RaY:Rbdd,'RaIe)gh, NC 276.13
... ............ . .
Name (jentry: S. Jones and Guys. Jones
Phone No.
Address 1870 Sanders Road, Merritti NC .28556
.g. A list: of previous: state orfed oral permits Issued for work On the project tract; Include permit Ourhbe.tt,porm.ktee,:and: Jttuin t g dates..
None
h. Signed consults.r i tw:agentauthorization form, if applicable.
i. Wetland delineation, if necessary.
1. :A signed .AFC: hazard notice for projects in oceanfront.an.d. inlet. areas, (Must be. signed by property owned
k' A statement.bf compliance with the N.C,,Environmental Polity Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure
ofpublic 1unds or.use of public lands, attach a statement documenting compliance with the.North Carolina Environmental Policy Act.
7. Certificatibmand Permission to. Enter on Land
i.tinderstand t.hat:any permit. issued in.respons.e.to thi.s.a.pplication will allow only the de.velopment described imthe application.
The p(oj6dt.Will be subject to the conditions and restrictions contained in the permit.
.1 Certifythat kirn authorized to: grant;. . and do in.fact grant. permission tompreseritatives of state and federal review.agencies; to
enter onAhe aforementioned lands in connection with evaluating information. related to this permit application and follow-up
cillow-up.
monitoring of the project.
I further certifythat the information provided in this application is truthful to the best of my knowledge.
Date March 4,,2008.. Print Name —Jay B.'' 0 . rison
Sig.nStaTe
Please Indicate A*�Ofijbation attachments pertaining to I Yqq.r pr,6�osproject.
�)' �t.
' .
JEDCM MP-2 Excavation.aindFill Information ODCM MP-5 Bridges and Culverts
EIDCM MP-3 Upland Development
ODCM. MP-4 Structures. Information

.Fgrim: 1mum P, _72
.. .. ...... ........ ... ..
10N.An dFILL,
(Except: ior birldges and culverts)
R 1
. . ... ... I .. .... ..... .... .. . ..... . MA2008
Attach this farm to Joint Application for CAMA Major Permit, Form DCM MR-9 . sure io­com016te.611 other sections of the Joint
Appliciatibri: that relate to� t: his.proposed. project.:.Please :nc
. i . *
fude: all suemcintai ifo
supplemental ... .. ... ­­ ..... ... r4A
... .. . ....
pescribe.belowthe. Pr(- hw�'U QtY DCM
.:PVTOse Of PrOPOs0d:eXca�ation and/.or:11:11-activities. All values should:be:given. in feet.
I Access I
Canal Boat Basin
NWL
Length
I.:Qepth
Existing:
.7F7
Final Project
Depth::
. .... . .. ...
MCA VATION.:
a. Amount of material be excavated from below NHW orNWLIn b.
cubic yards...
(5 b;es Tare) to be W.CaVatedInclude .coastal wetlands/marsh d.
(OVY), submer.ged.PqUOtic.vegetati6n(SAV), Shell bottom(Sb,
:or other wetlands
:—(W...L)?I It anyboxes checked, provide the
number of square affec#ed. Qcw D Av
09B
OWL. . ONQne
(i1)i DescribL- the putpase- of the excavation in:these areas:
2. DISPOSAL OFEXCAVATEDMATERIAL
a. Location of,disposal area-. .... ..
Tempor.a. ry:.Spoil: Area is Existing Read
C.: (i).Do YOU clakri.fitl6to disposal area?'
Oyes ONO, DNA
VQ:(f no-, attach wlettergrantjhg permi
SSIOft from the owner
Do e s j he disposal area include any coastal WOtlands/marsh
(CW), submerged aquatic vegetation (SA10, shellbottom (Sa),
orotherwetlands :(WQ? If any boxes are checked,. provide the
number of square feet affected.
Elm .0SAV
EIS8.
OWL ®None;
.(i.i):Dia8ctjbd:.th'.4:pUrpose...of.:dlspOgal'ih these areas-
3.. SHORELINE ST—ABILIZATIOW . .... .......
Vf develoOment is a wood.groio, use MP-4 —,Structures)
Boat Ramp :Rock drain
NA
i4A
Rock (excluding
Breakwater 1. shoreline
:NA
.NA
.. ... .. .. ....
This se I .section not
t qppjic,91)10.
Type of material to be excava,"_
fth-groujid excavation1n cubicords.
. .. ... ......
El This section not applicable
b. Enmenslonspf disposal area,
d, (I) Will a disposal area be available for ftkure maintenance?I
NYes ONO, ©NA
(ii) If yes, where?
Does the disposal ln.cludle..any area.1n.the Water?
OYes ONO DNA.
(ii) If yes, how much: 4er area: is aftect4d?
D This: sedion not applicable.

of DCM MP-2 (Excavation and Fill, Page 2 of 2)
a. i,ype oT snorepne staofmation:
ElBulkbead ORiprap ,[Breakwater/Sill ElOther:
C. Ave rage: distance wat6 rward of:NH.W: or NWL 7
e. Type of stabilization material:
class B Marl
g. Number of.square feet of fillAo be placed. below w6tO 1661.
Bulkhead backfill Riprap-LO.
Breakwater/Sill Other
i. Source of fill'material.
Clarles Quarry
(Exduding Shorske Stabilization)
0).An,vount of materialto be placed in the water
aiQ: Dimensions of fill area.
(w) Purpose of. Fill .
-71-z I
F
b. Length', 40' 1 VS,
Width: .5' MAR 1 9 2008
d.. Maximum distance waterWard of NHWor::NWL:- 3?
A/Jureriead. Cit
E (1) Has there been shoreline erosion during, preceding I . 2
months?
F—]Yes ®No El NA
(ii) If yes,. state amount of erosion,and sourceof erosion amount
information.
h... Type R Olf Material.
Class iB Marl
171 This section.ndt applicable
(i) Will fill material: be placed, in coasts [:we tlandr./mars.
:(.CW)*.,
submerged aquatic vegetation (SANO, shell.lbottorn (S4.),pr
other wetla, . nds.(WL)*? If any boxes , a . rechecked, provide the
number of square: feetaffedad..
OCW DSAV Ei'58
OWL ®None
(ii) Describe the purpose of the fill in these areas:
a. How will excavated or fill material be kept on site and'erosion b. What type of construction equipment will be used (e.g., dragline,
..controlled? backh6% or hydraulic dredge)?
Slit encevand TRSC-B% Typical R6ad.Constru6tidn Equipment
c., (i) Will navigational aids be, required as a. result 6fthe project? d. (1) Will wetlands be crossed. In transporting equipment to project
OYes ®No :EINA: site? E]Yes ONo DNA
(H.) if yes explain what type. and hOW they M11 be tmpiernented. (ii) If yes, explain steps that Will �betaken to avoid or minimize
environmental impacts.
,Date pricant
SIR 1321, Straight Road Pipe: Replacemeats WBS Element .
:Number 26.206911
'Project. Niamir
Jay B. Johnson
plicant Name.

Form DdM MP-.2.:(eiwaivation. and F0111 Page, 1,�C2)
a. Type of shoreline stabilization:
[}Bulkhead -.URIprap QBreakwateriSill 00ther:
C. Average.distame waterwardof*NH*WorNWL: 7
e. Type of stabilliiation material;:
Class Marl:
6. Nymber'of square feet of fill: to be placed beloW W6tO level.,
BUlkhead bal*fill- Ri.prap. 30
Breakwater/,5111 Other
her
L Source.of fill material.
Clarles Quarry.
0. :Length-. 40'
Width: 6' kV/
cl.008
Ma>dmurn distance waterward of NHW or NWL 3'
(1) Has there.been shoreline erosion dur i ng preceding 12
months?
DYes ONo EINA
(ii) If yes,..state amount of erosion. and source of erosion amount
nformdtion.
h.: Type ofi fill inaferlal.
Class B Marl
4.. OTHER., FILL. A CniflTIES 0 This section hot opplid6b16 .
(ExpAudiag ShorsIV76 Stabilizatton)
(1) Will fill. mate riM babrought t6 the Mel ❑[JYe []No :WNA 15. (iy Will fill: material be placed: in coastalwetiands/mar.sh (M)
submerged aquatic vegetation (MV), shell or
other Wetlands.(WL)? If any box" are checked, provide the
i) Amount of materialto be placecfirt thewater number of square feet affected,
ffi.) Dimensions of fill area. E1CW EISAV EISS
(N).purp.o.s* offill . OWL ®None
(ii) Describe the purpose of the tit in these areas:
.a. How witexcavated or fill material be kept on.site and erosion b. What type of construction equipment will be used (e.g., dragpne,
..controlled? baokhoe, or *hydraulic dredge)?
SI.It fences and TIRS.-C-.B.s Typical Roa.d,Co.nsbi.ibtiort.Equ.i.pm.em,t
c- (Q Will navigational aids be:required as a. result of the project? d. (1) Will wetlands be crossed in trans porting equipment to. project
Oyes ONo:EINA. site? Elyes 0No CINA
(IJ).1f yes, ,OX.pla.in'What type and hdW they will be Implemented. (ii) If yes, explain steps thatwill.be,taken to avoid.or minimize
environmental impacts.
MarchAl 2008
Date plicent SignatL
8R 1321., Straight Road Pipe: Reptacemeats WBS Elernenf
Nui-nber 2B.206011
Project Name
Jay B. Johnson
0 ipant Name

ForMUMMP.5
BRIU6ES and CULVERTS
�z
M A R r 9 2008
Attach. this.foFm to Joint Applicationjor CAMA:Mqjbr.Perm-ft, Form DCM. MP,4— Be sure to complete sections plete. all othersec1onso
.
Application that relate to this prop
osed
ftreheaU nirm
1. BRIDGES 0 This section not applicably
a. Is the. Proposed bridge,; b, Water body to be crossed by bridge:
OCommercial OPublic/Government OPrivatetommunity
c. Type of badge (construction material).:
.... ... .....
e. (i) Will proposed bridge.replace an.existing bridge? Dyes QNo
If yes,
(ji) Length of.existing*br1d.ge:
(iii) YVidith of existing bridge.
9
(iv) Navigation clearance underneath exist[ . ng.brldge.
(Y) Ma aiu,. or a part of, the existing
sting bridge be removed?
{Explain)
g, Length of proposed:bfldge::
:1. :Will the proposed bridge affect existing water flow? Oyes ONo
If yes; explain:
.k. Navigation clearance underneath -proposed bridge.-.
cl. Water depth at the proposed crossing at NLW or NWL:
L Will proposed bridge replace an existing culv rt7 Dyes
ONO
If yes,
(10 L.ength of existing.culvert:
(111).Width of existing culvert,
(iv): Height of the e top of th e. ex istirV culve It.a bovethe N H W or
NWL'
(v) Will all, or a part. of,, the existing culvert be removed?
(Explain)
h. ,proposed bridge::
j. Will the proposed btidgwaffectnavigatiomby reducing or
increasingthe existing navigable opening? OYes ONo
If Yj§s, explain:
I. Have you contacted the U.S. Coast Guard concerningtheir
approval? s El No:
If yes; explain--
m. Wlitht,15rbposLid.btidg.eibrbs6W6tiand§:.botftiiiieid.nb.fiaVioable- ri. Height of proposed b ridge above wetlands:
waters? DYes ONo
IT yes,: expl.sin.:
2, C UL VER TS
This section not appffbable
41Number of culverts proposed., :2 b. Water bodyin: which the culvert is to be placed:
Brown Creek
4: Form continues an back>
ci,. Type of culvert: (construction material)'
CRAP

Form DC -5 (Brid9ps and C+%Werts. gage 2 of Q
i
d. (i) Will proposed culvert replace an existing bridge?
OYes 'IRNo
ifyes,.
(i) Lenp. of existing bridge:
(M)Width of existing bridge:
(iV) Navigatlbn.cleatance underneath existing bridge:.
(v) Will. all, at a part of, the, existing bridge be removed?
('Explain)
f Length:of proposedoulvert: 60'
h. Height of the top of the proposed culvert above the NI-IW orIVWL.
2V
j: Will the: proposed cuivert affect navigation by reducing or
increasing the existing riavigable opening? Ones ON6
If yes, eXptain:
e. (i) Will proposed culvert replace an existing culvert?,,. 200$
0Yes ONO //pp
If yes, " g(7' d City ®CAA
(Ii) Length of existing culvert(s):
(lit) Width of existing euivert(s): 7.25':ea. 14.5"T6tal
(iv) Height of the top of the existing culvert above the NHW or
NVVL 2_5'
(v) Will all, or a partof, the existng culvert be removed? .
(Explah) All of the Existing Culverts Will Be Replaced
g. Width of proposed culvert: 7.9' ea 15:8' Total
i. Depth of culvert to be:buried below existing bottom tiontour.
I
k. Will: the proposed culvert affect: existing water flow?
OYes KNo:
If yes, explain:
E3i; AVATION and FILL q This section not applicable:
A M Will the placement of the proposed bridge or culvert require any b. (i) Will the placement of the:proposed bridge or culvert require any
excavation below the NHW or NWL? 0Yes ONo excavation within coastal weflandstmarsh (CW), submerged
Ifyes, aquatic: vegetation.(SAV), shell bottom (SB),.or:otherwetlands
:
(WL)? If any boxes.are checked,. provide the number of square
(ii).Avg._aength of area to be excavated: 64' feet affected:
(lii) Avg, widtht:of area to be excavated,22.8' OGv+r OsAV Osg
(iv).Avg. depth of area to be. excavated:: 4.6 :OWL WNone
(v)Amount oumaterial to.be excavated.in cubic yards: 6566
(,i).oescribe the purpose:af the excavation in.these:areas:.
c. (i)Will the placementof #lie proposed bridge or, culvert require any
high -ground excavation? MYes: 0140
Ifyes,
(ii):Avg. length of area tc be. excavated:. 48.
(iii) Avg., width of.area to be excavated, 27'
:(iv Avg. depth of area to be excavated 2_.5
(v) Amountof.material:to be excavated in cubic yards: 3240T

Forryi OCNCI . MP-,S (Bridges anti Cql.vorts, Page 3.*.f:4)
d., If the placement of the:bridge crculvert inVolvetany excavation, please complete theJol I lo 4 wing-
(1) Lb.cation:of the soil disposal area: Temporary Spoil
Area is in the Existing Road
........ 2008
(iQDimensions of the spoil disposal area 100!x2O
(ii) Dq you claim tMe:to the disposal area? ElYes ONO (ifno,.attach alet.torgriin#ngp6rj," n fro in.
� DC
(iv) Will, the disposal area be available (E
for future maintenance? yes ONO CiLy
(v). boes the disposal area Include- any coastal wdtlan*dsimar.sh:{PW),.:tUbrTieroeidt4Ui�tic ' vegetat
bott.om:(,513)? , ion (SAVs), other we.tIands.(VV.L),. or shell
OCW OSAV OWL :.[188 ®None
Ifanyboxesare-checked, give dimensionsif different feorn (Ii),. above.
(vi) Do s the disoosal a
rea.include any area belowthe NHW or:NWL?: ? ❑Yes
ONO
if yes, give: dimensions: If different from (h) above,
0) Will the Placement of the proposed bridge or culvert:result in. any
.fill (othe r. than excavated. material described in, Item -d above)to
.be. Placed beloWAHW. or NWL? Ys D . .
e: ®NaO
:If yes.,
(ii) Avg.Jength of area to be filled:
(iii) Avg, width of area to be filled,
(iv) Purpose:or fill:
tl: (i):Wtil
placiement.of.the proposed bridge or culvert result In any
fill (other than excavated material described in Item dabpV.e)to
be placed on high -ground? nyes . :
ONO:
if yes;.
(ii) Avg. length .of area to be filled- .40'
(iii) Avg. width otarea to be. filled: 51
(iv). Purpose of fiHI:'Plac.em.en I t of Additionai.*Rip Rap on
Existing Rip..Rap for Stabilization
f. (1) W1111 theplacem en t oft heproposed bridge or culvert r6s it I
U nany
fill:(otherthanexcavated material described In Item d ablove).to
be Maced-within coastal wiatlands/marsh (Q.W), submerged
.aquatic ve.getatio n (SAW), shell bottom, (S:8), or other wetlands
CWQ? If.any:boxe sarechecked provide: the number ofsquare
feet affected.
OCW OSAV
OWL. UNone
(1):D6§ddb0:0e pwppse of the excavation in these areas:
14. GENERAL
V> Will the proposed project re4uir,6 the reloca.tion.,of any existing b. Will the proposed prqj act require the construction of any temporary
utility lines? Oyes ONO detour structures? Dyes ®No
Jf.yesi explain; If yes, explain:
If.this portion ofthe proposed projigct has afready, received
approval mom kcal autholffies, please: attach a.c6py: of the
approval.or certification.
< Form continues on back>
0. Will the proposed project require any work chanfie!0
d How will excavated or Fill material be kept onsite-and erosion
©Yes :ONO
lf y0s, complete Form DCA!-.MP-2,, Turbidity Curtains and.Silt Fences will be used'to ret
material on -site

FOrM D.CM MO-5 (Bridges and Culverts, Page 4 of 4)
!e, What: fype. of . constructiomequipment:wMill be used (for example,
dragline,backhoe, or hydraulic dredge)?.
Typical Bridge Construction Equipment
-:g., Will the plapernent of the proposed bridge or culvert require any
shoreline stabilization? ... OYes ONo
If yes; COMPW6 Ibini MR2, S'60on:3.forshotollho
Stabilizaiffof) only:
March 4,2068
Date
NI-21'Pio.oRoo(acements., SR 1321,-StrAight Road over Brown
Creek
Prpjact.Name.
jay:B. JlGhnson
Ap:
�licant Name.
plicant Signatu, ry"T A
V
all_ "; ",�i
f. Will-Wetlandsbertrostedintrans i transporting equipment grojs7:
0 rO�Olad I
If yes, explain steps that will be taken to avoid or minimize
enAronme.Mal impacts,

INC 00
Bra c=)
co
GENTRY S10AlES AND
OqQY S. JONES
.187 SANDERS ROAD
MERRffT, NC . 28556
DBK.197- PG. 724
PROPOSED TURBIDITY C R TAIN
Zvi
EXISTING RIP RAP.
EXIVINO 2.0 8TIK613*xfacmp
PROPOSED 2695*x6�1x&O'CAAP
,&XISrWG RIP —d8e,-
PROPOSED TURBIDITY CURT.
:GENTRY S. JONES AND
GUY So JONES
1870 SANDERS ROAD
MERRITT, IVC .28556
DBK. 1971, PG. 724
MARCH 4,2008
SCALE.: /`—'50�'
CREEK
FOR PERMITTING ONLY
NOT FOR CONSTRUCT10h

R 20
S.
132.1 1
6/
NFL
:Bed :god devotion
MO-PO-SED 2: @ 95" x 67-" x 60' CM PIPE ARCHES
/
US TO 27
EXCAVATIOAF ABOVE NWL
4 8 X 2.7' z
1296 S 0. F T.
EXCAVATION BEI 0 VIM
L 6 4' X22-4-8' 148.0 SC �FTo
'atlon
Oding
DRAWING IS NOT TO SCALE

Pipe Replacements, SR 1321., Straight Road. over Browy,
�creek; Pamlico County
MAR 1 9 2008
Seed alI'disturbed areas as soon final I
0 A as: grading is completed.
• dean out and/or rework all temporary sediment .control measures. after
significant rainfall evetw: (9r.as otherwise needed). These measures should. be
permanent maintained until a perm t vegetative cover is established and project -is
flope.Justallation Schedule
.... .. .. .. ..... .. . ... .
• install devices: . ....
rosiontsedim. !zo I per pans.
i -exitp.. I mro
-R
Wng�.:,as:m.u.s .-.h:a* possible, material .and sediment OOOV.9 MA" "al WWI. M
'from: entering the stream and/or -escaping: from the project.
• Prepare pipe foundation while taking care to limit material and sediment from
..entering the stream. and/or escaping from the project. Where possible new
.grade should be below the existing streambed. Bedding material will be washed
Stione.
:6 'lace new pipe and compact rill.
•I.nstall slope protection:. on outlet. and inlet ends of: ipipe.(QA*ssB:Granite:.:riora
.......
P)
0 h permanent vegetation as soon as.:possible -EAablis permane. .. .. .. ..... . possible;
..
w Remove sediment control devices after project has stabilized .and: Permanent
vegetative cover. is established..

LEGEND SHEET
00
CZ)
3
D!fflISE FLOW THROUGH *.W.ETLANDS
'VEGETATED:
UPLAWS BEFORE ENTERING IYET AND
z
SOL:qw" CONTROL LEOM
TYPICAL EACH.SaT
TEMPORARY ROCK SILT CJ-IECK
>
TYPE -A UPLANDS
z
aw
Si: HASN. .M 8:
��
u.
'.iG.
M"ARy'A=,SlLr*CcX TYM-A.
C
a%
4 i-
.,.:. TEMPORART RM SILT b4ECK TYPE-B.
o
TOPOROY $ILT FENCE.
almaom
SILT BASIW TYPE
6j
Qum owa
cl
Ld
D=TM OF FLoW
DIFFUSE
FLOW
DETAIL
DIFFUSE FLOW
NT-S
----- 4134 WETLANDS. FILL AREA.
T MWORANT W SILT. 0=9 TYPE !0'
M.
DITOCH
�AM DF PAYP.ElfT
RIVER RIPA IAN BUFFER � - E
404.WETLA#DS
CdAVA , L WETLANDS
3* GL CL i—MAn LM CHANNEL.
—OPEN WATER: IMPACTS
PROP.OSED SILT L FENCE:
EXISTING FILL.
UTILITIES LEGEND,
TYPICAL, EACH SHEET
..........
POWER POLE
AG
TELEPHONE PEDESTAL
CABLE TV P.MTAL
SEWER CLEAN OUT
VAMP VALVE:
FIRE HYDRANT
VOTER MET&:
EXISTING IRONI PIPE
PROPERTY CORNER:
PROPERTY.LINE
GRASS-UNED CHANNEL
TRAPEZOIDAL DITCH SECTION
.z .
X -SECT& AREA tfiJ . 80 : 10'
rOP WfDrH tl-).= B t 20Z
AREA TO BE
FILLED OR
DISTURBED
UNDISTURBED AREA
FABRIC, BURI . ED BELOW f
EXISTING: :GRAfE--j
SILT FENCE
DETAIL
NTS
PROPOSED SILT FENCE
WETLAND .. ..... VAR. 0'-6' 1 1: VAR, Wit'. _4
EDGE: OF EXIST. ROAD "EDGE OF. EXISTRO40

C.)
.LE END SHEET
.SPECIAL SEDIMENT CONTROL. �ENCE
i FT.
fS t
VAfdABLE 114 WIRE MESH
DIMENSAN
ANT CONTROL 570NE
SEDIMENT CO
I F7
WATER -
GENERAL. NOTES:
USE N0.3 OR NO.57:STO)VE FOR. SEDIMENT
CONTROL, AND - PAY FOR AT THE CONTRACT UNIT
PRICE' P,5R'T0)V SEDIMENT CONTROL STONE'
41,Z HARUNARE CLOTH 24 GAUGE WIRE MESH
.WlTlq �4. XCH MESH OPENINGS
IkMALL 5 FT SELF FASTENER ANGLE STEEL
POST 2 FT.DEEP MINIMUM
INSTALL 6 FT. LONG, 3 IN. DIA WOOD POSTS
3 FT.DE8P MINIMUM
SPACE POSTS A MAXIMUM OF 3 FT.
TUR81DITY CURTAIN

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
/y) R . A L-M>J �. 41�5 d
-7j C/t21)7o4rT )eW
8F'W, A c
Z85�10
A. Sig tuts
' ❑ Agent
X (J ❑ Addressee
B. Received by (Printed Name) C. late 4 Delivery
c1 I'iC l �-N ac�QY� 3
D. Is delivery address different from item 1 ? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Seryice Type
(Certified Mail ❑ Express Mail
❑ Registered ❑ Return Recelpt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label) 7005 3110 0000 2029 4053
PS Form 3811, February 2004 Domestic Heturn Receipt 102595-02-M-1540
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
m2. d'A /000
l
RA Ie-i0 ) N C, c a-�L 12
A. Signat
❑ Agent
X r V ❑ Addressee
B. ec ived y 'Tte Na e) Date of Delivery
D. Is deliveryaddress d' e11t %'Yii ft ❑Yes
If YES, enter deliv 'a ress belo ST No
O
�1qq T
� m l2ZOOB m •.
t
3. Service Type
,51eertified Mail
❑ Exp s ail.-'
❑ Registered
❑ Return 'Receipt for Merchandise
❑ Insured Mail
❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number (7005 3110 0000 2033 2304
Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
9FN1-" S . ��E-s
G S. � a"'� s;:S n I
�-� O 5, 1,,D E-L KCI
2 5.5 (o
A. Signature
X / ❑ Agent
❑ Addressee
B. Receiv �'ed f a i� DAhe O f) liv e
D. Is delivery address different from item 4? Lr Yes
If YES, enter delivery address below: ❑ No
3. Service Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
Q
ID
i
2. Article Number
(Transfer from service label) 7007 3020 0001 0962 0489
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

Message Confirmation Report
Narre/Number
- 912528303341
Page
2
Start Time
APR-15-2008 04:OOPM TUE
Elapsed Time
01' 04"
Mode
STD ECM
Results
[ O. K]
APR-15-2008 04:01 PM TUE
Fax Number 2522473330
Name DCM MHD
DIVISION OF COASTAL MANAGEMENT
Alf",t'Av.
RCDENR
f'' NC"T" C-... Dev. Z.t C.
FnMRONNCST MD NMVf RCSOURCCJ
TO:
OFFICE:
TELEPHONE: ( ) FAX• ( )y/ - 35 L, I
FROM; 6A,—. O'L�'— ---- -----
VY
Morehead City Office
400 Conunerce Avenue
Morehead City, NC 28557-3421
Voice: [phone]
FAX: [phone]
Re:
DATE SENT:4Z7V
TOTAL PAGES INCLUDING COVER SHEET:

DIVISION OF COASTAL MANAGEMENT
�.
;ajaA�� NCDENR
ENVIRONMENT AND NKuRAL RE50URCE5
TO:
OFFICE:
TELEPHONE: FAX: " 3�
• FROM: &L�-
Morehead City Office
400 Commerce Avenue
Morehead City, NC 28557-3421
Voice: [phone]
FAX [phone]
DATE SENT: 4 1 I J(---/(b
TOTAL PAGES INCLUDING COVER SHEET:
2

AMA / 1�i DREDGE & FILL N? 51036
Y GENERAL PERMIT Previous permit # —
L-- ew ❑Modification CComplete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources iJ O
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 6 -7
ules attached.
Applicant Name Project Location: County
Address I U)C 7 Street Address/ State Road/ Lot #(s)_
CityVi Q State N ZIP ��� �' �� iJ'� l ,fit ! i�,r 7�� f�-�2 132 9
i'/'
Phone # (�) �30 ���l o Pax # (_} Subdivision
Authorized Agent `s% °�`�6n City pe- rf /N C ZIP
Affected ❑ CW Elrtw � r A B�r's ❑ PTS
AEC(s):
❑ OEA ❑ HHF ❑ IH ElUBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes /(no PNA yes no Crit.Hab. yes / no
Phone # (`) River Basin N e"'
Adj. Wtr. Body -f,-1'*-.1'-J z (iati/man /unkn)
Closest Maj. Wtr. Body ' �'` � Jew
Type of Project/ Activity c� J'fif " �� �>r✓o 1 S X 6 )( 6 a c_ 1'vzl /J z r e pla c e
Pier
Platfc
Finge
Groii
Bulki
Basir
Boat
Boat
Beac
Othf
Shor
SAM
Sand
Mom
Phot
(Scale: % / / A )
JOCK)iengcn
rm(s)
atorium:
9
I
---
—
--
—
— --r--
1
k
- -
- _T-
I
I
pier(s)
--
-
--
-
- -
I Ef
--
-
length
number --
I
-
ead/ Ri ra length
-
-
- --
- --
-
-
h
-
-
avg distance offshore ^�.
max distance offshore - -- {-\,- - -u: V
T7teG
channel
cubic yards
—i--1—
i
ramp _ 0
i l
- - - -
louse/ Boatlift -
_
~-
! I_7
-
I
7+
i I I—
J Bulldozing - � }- i
�f
I J..
f
. _
—�.---
...-
--
'
�u IV �+J rc qj'
-- -
i
I
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eline Length
not sure yes no
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bags: not sure yes
n/a 0 noos:
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Waiver Attac e yes no -------
A building permit may be required by: A►`^' c r
Notes) Special Conditions
.-3 .•// n 4. D
Agent or Applicant Printed
Signature • Please read compliance statement on back of permit
_$'y o o 0 6 91 j
Application Fee(s) Check #
�e note on back regarding River Basin rules.
PermitO cer's Signature
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name