HomeMy WebLinkAboutNCDOT - 70430❑LAMA / ❑ DREDGE & FILL N2 7 04_0 A g C D
GENERAL PERMIT Previous permit #
❑New ❑Modification ❑Complete Reissue ❑Partial Poissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concernpursuant to 15A NCAC
� ❑Rules attached.
Applicant Name Project Location: County
� _
Address _ Street Address/ State Road/ Lot #(s)
City State ZIP -- --
Phone # O E-Mail Subdivision --
Authorized Agent City ZIP
-
Affected ❑ EW ❑ PTA ❑ ES ElPTS Phone # O _ River Basin
Affected ❑ OEA ❑ HHF ❑ I ❑ H UBA ❑ N/A
AEC(s): Adj. Wtr. Body (nat /man /unkn)e
❑ PWS:
Closest Maj. Wtr. Body
ARW vps / no PNA Yes / no.
Type of Project/ Activity
Pier (dock) lei
Fixed Platforn
Floating Platfc
Finger pier(s)_
Groin length
number
Bulkhead/ Rip
avg dista
max dist
Basin, channe
cubic ya
Boat ramp _
Boathouse/ B
Beach Bulldo:
Other
Shoreline Lei
SAV: r
Moratorium:
Photos:
WaiverAttac..__.
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed
Signature ** Please read compliance statement on back of permit"
Application Fee(s) Check #
(Scale: �' )
❑ See note on back regarding River Basin rules.
Permit Officer's Printed Name
Signature
Issuing Date Expiration Date
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, certify that this project is consistent with 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 Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on how to complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
Fax: 252-247-3330
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax:252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:910-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
Revised 7/06/17
NC Division of Coastal Mgt. Application Computer Sheet, Page 3 of 4)
Applicant:
� v �W -7
Date: a� f� t
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp, impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)amount
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
i
Dredge 2-'-Ff11 [Both [Other ❑
Dredge [" Fill ❑ Both ❑ Ooer ❑
S�
l
Dredge E Fill [J-Both [Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other El
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAS7 n www.nccoastalmanagement.net revised:02/15110
= WL1
APPLIune for
Major Development NMI[
Gast revised 12/27/06)
North Carolina DIVISION OF COASTAL MANAGEMENT
1. Primary Applicant/ Landowner Information
Business Name
Department Of Transportation
Project Name (if applicable)
US 70 at North Harbor Pipe Replacement WBS#:2.201611
Applicant 1: First Name
Jay
MI
B
Last Name
Johnson
Applicant 2: First Name
MI
Last Name
If additional applicants, please attach an additional page(s) with names listed.
Mailing Address
PO Box
1587
City
Greenville
State
NC
ZIP
278351587
Country
USA
Phone No.
252 - 439 - 2821 ext.
FAX No.
252 - 830 - 3341
Street Address (if different from above)
City
State
ZIP
Email
jbjohnson@ncdot.gov
2. AgentJContriictor Information
Business Name
tIECE►VED
Agent/ Contractor 1: First Name
MI
Last Name
JU N 082018
Agent/ Contractor 2: First Name
MI
Last Name
-N1 H0 CIT-Y
Mailing Address
PO Box
City
State
ZIP
Phone No. 1
- ext.
Phone No. 2
ext.
FAX No.
Contractor #
Street Address (if different from above)
City
State
ZIP
Email
<Form continues on back>
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Form DCM MP-1 (Page 2 of 4)
APPLICATION for
Major Development Permit
3. Project Location
County (can be multiple)
Street Address
State Rd. #
Carteret
US 70 250' north of SR 1466
US 70
Subdivision Name
City
State
Zip
N/A
Beaufort
NC
28516 -
Phone No.
Lot No.(s) (if many, attach additional page with list)
N/A - - ext.
N/A,
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
White Oak
Fulcher Creek
c. Is the water body identified in (b) above, natural or manmade?
d. Name the closest major water body to the proposed project site.
®Natural ❑Manmade ❑Unknown
North River
e. Is proposed work within city limits or planning jurisdiction?
f. If applicable, list the planning jurisdiction or city limit the proposed
❑Yes ®No
work falls within.
N/A
4. Site Description
a. Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
50,
N/A
c. Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high water) or
N/A, I
NWL (normal water level)
(if many lot sizes, please attach additional page with a list)
3' ❑NHW or ❑NWL
e. Vegetation on tract
Maintained grasses and coastal wetlands
f. Man-made features and uses now on tract
Asphalt road
g. Identify and describe the existing land uses adjacent to the proposed project site.
Coastal marsh and residences
h. How does local government zone the tract?
i. Is the proposed project consistent with the applicable zoning?
N/A
(Attach zoning compliance certificate, if applicable)
❑Yes [-]No ®NA
j. Is the proposed activity part of an urban waterfront redevelopment proposal? ❑Yes ®No
k. Hasa professional archaeological assessment been done for the tract? If yes, attach a copy. []Yes ❑No ®NA
If yes, by whom?
1. Is the proposed project located in a National Registered Historic District or does it involve a []Yes ❑No ®NA
National Register listed or eligible property?
<Form continues on next page>
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Form DCM MP-1 (Page 3 of 4)
APPLICATION for
Major Development Permit
m. (i) Are there wetlands on the site? ®Yes ❑No
(ii) Are there coastal wetlands on the site? ®Yes []No
(iii) If yes to either (i) or (ii) above, has a delineation been conducted? ®Yes ❑No
(Attach documentation, if available)
n. Describe existing wastewater treatment facilities.
N/A
o. Describe existing drinking water supply source.
NIA
p. Describe existing storm water management or treatment systems.
N/A
5. Activities and Impacts
a. Will the project be for commercial, public, or private use? ❑Commercial ®Public/Government
❑Private/Community
b. Give a brief description of purpose, use, and daily operations of the project when complete.
The 2 existing 50' long 42" corrugated metal pipes are failing and will be replaced by 2 50' long 42" corrugated aluminum
alloy pipes. The proposed pipes will keep the roadway from collapsing, thus preventing injury and death.
c. Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type
of equipment and where it is to be stored.
Typical roadway construction equipment will be used, including but not limited to tracked excavators, dump trucks, flat bed
trucks, back hoes and boom trucks.
d. List all development activities you propose.
Pipe replacement
e. Are the proposed activities maintenance of an existing project, new work, or both? Maintenance
f. What is the approximate total disturbed land area resulting from the proposed project? 1140 ® �
g. Will the proposed project encroach on any public easement, public accessway or other area ❑Yes ®No ❑NA
that the public has established use of?
h. Describe location and type of existing and proposed discharges to waters of the state.
N/A �Ch(I-hNH® CIT
i. Will wastewater or stormwater be discharged into a wetland? ❑Yes ®No ❑NA
If yes, will this discharged water be of the same salinity as the receiving water? ❑Yes ®No ❑NA
j. Is there any mitigation proposed? ❑Yes ®No ❑NA
If yes, attach a mitigation proposal.
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Form DCM MP-1 (Page 4 of 4)
APPLICATION for
Major Development Permit
6. Additional Information
In addition to this completed application form, (MP-1) the following items below, if applicable, must be submitted in order for the application
package to be complete. Items (a) — (0 are always applicable to any major development application Please consult the application
instruction booklet on how to properly prepare the required items below.
a. A project narrative.
b. An accurate, dated work plat (including plan view and cross -sectional drawings) drawn to scale. Please give the present status of the
proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties -
a. The appropriate application fee. Check or money order made payable to DENR.
f. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
Name North Harbor Owners Asso Phone No.
Address 146 North Harbor Lane, Beaufort NC 28516
Name Gerald & Ruth Moore Phone No.
Address 5113 Holly Lane, Morehead City 28557
Name Phone No.
Address
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
h. Signed consultant or agent authorization form, if applicable.
i. Wetland delineation, if necessary.
j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
k. A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure
of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
7. Certff cation and Permission to Enter on Land
I understand that any permit issued in response to this application will allow only the development described in the application.
The project will be subject to the conditions and restrictions contained in the permit.
I certify that 1 am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up
monitoring of the project.
I further certify that the information provided in this application is truthful to the best of my knowledge.
Date May 21, 2018 Print Name Jay B Johnson
Signature �.4 A ___
Please indicate application attachments pertaining to your pr sect project.
®DCM MP-2 Excavation and Fill Information ®DCM MP-5 Bridges and Culverts
❑DCM MP-3 Upland Development
❑DCM MP-4 Structures Information
252-808-2808 .. 1-888-4RCOAST ., www.nccoastalmanagement.net
Form DCM MP-2
EXCAVATION and FILL
(Except for bridges and culverts)
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
Describe below the purpose of proposed excavation and/or fill activities. All values should be given in feet.
Access
_
—�— Other
Chan(NLW el
Channel
Cne
Canal
Boat Basin
Boat Ramp
Rock Groin
Rock (excluding
Breakwater shoreline
stabilization
NWL
Length
Width
Avg. Existing
NA
NA
Depth
Finai Project
NA
NA
Depth
1 EXCAVATION ®This section not applicable
a. Amount of material to be excavated from below NHW or NWL in b. Type of material to be excavated.
cubic yards.
c. (i) Does the area to be excavated include coastal wetlandstmarsh d. High -ground excavation in cubic yards.
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW ❑SAV _ ❑SB
OWL ❑None
(ii) Describe the purpose of the excavation in these areas:
2. DISPOSAL OF EXCAVATED MATERIAL ®This section not applicable
a. Location of disposal area b. Dimensions of disposal area
c. (i) Do you claim title to disposal area? d. (i) Will a disposal area be available for future maintenance?
[]Yes ❑No ❑NA ❑Yes []No ❑NA
(ii) If no, attach a letter granting permission from the owner. (ii) If yes, where?
e. (i) Does the disposal area include any coastal wetlands/marsh
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW ❑SAV ❑SB
OWL ❑None
(ii) Describe the purpose of disposal in these areas:
(i) Does the disposal include any area Ars .
❑Yes ❑No ❑NA
(ii) If yes, how much water area is affected? O $ 201$
aUN
DC�_MHD
252.808-2808 :: 1-8884RCOAST :: www.nccoastalmanaoement.net revised: 12/26 06
Form DCM MP-2 (Excavation and Fill, Page 2 of 2)
3. SHORELINE STABILIZATION ❑This section not applicable
(If development is a wood groin, use MP-4 — Stnrctures)
a I ype of shoreline stabilization.
[]Bulkhead ORiprap ❑Breakwater/Sill ❑Other:
c Average distance waterward of NHW or NWL: 8
e. Type of stabilization material:
Granite Riprap
g. Number of square feet of fill to be placed below water level.
Bulkhead backfill Riprap 280
Breakwater/Sill Other
i. Source of fill material.
b. Length: 20
Width: 10
d. Maximum distance waterward of NHW or NWL: 12
f. (i) Has there been shoreline erosion during preceding 12
months?
❑Yes ❑No ®NA
(ii) If yes, state amount of erosion and source of erosion amount
information.
h. Type of rill material
Sand
4. OTHER FILL ACTIVITIES ®This section not applicable
(Excluding Shoreline Stabilization)
a. (i) Will fill material be brought to the site? ❑Yes []No ❑NA b. (i) Will fill material be placed in coastal wetlands/marsh (CW),
If yes,
(ii) Amount of material to be placed in the water
(iii) Dimensions of fill area
(iv) Purpose of fill
submerged aquatic vegetation (SAV), shell bottom (SB), or
other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW ❑SAV ❑SB
OWL ❑None
(ii) Describe the purpose of the fill in these areas:
5. GENERAL
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? backhoe, or hydraulic dredge)?
NCDOT BMP's Typical road construction equipment
c. (i) Will navigational aids be required as a result of the project?
❑Yes []No, ®NA
(ii) If yes, explain what type and how they will be implemented.
May 21, 2018
Date
US 70 at North Harbor Pipe Replacement WBS#:2.201611
Project Name
d. (i) Will wetlands be crossed in transporting equipment to project
site? []Yes ®No ❑NA
(ii) If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
Jay B Johnson
Applicant Na e
Applicant rat
252-808-2808 :: 1-888-4RCOAST :: www.nccoastatmanagement,nat revised: 12/26/06
PM M MP-5
BRIDGES and CULVERTS
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
rl. BRIDGES ®This section not applicable
a. Is the proposed bridge: b. Water body to be crossed by bridge:
❑Commercial ❑Public/Government ❑Private/Community
c. Type of bridge (construction material):
d. Water depth at the proposed crossing at NLW or NWL:
e. (i) Will proposed bridge replace an existing bridge? ❑Yes ❑No f. (i) Will proposed bridge replace an existing culvert? ❑Yes ❑No
If yes, If yes,
(ii) Length of existing bridge (ii) Length of existing culvert:
(iii) Width of existing bridge: _ (iii) Width of existing culvert
(iv) Navigation clearance underneath existing bridge (iv) Height of the top of the existing culvert above the NHW or
(v) Will all, or a part of. the existing bridge be removed? NWL:
(Explain) (v) Will all, or a part of, the existing culvert be removed?
-- ----- __---_ (Explain)
9 Length of proposed bridge h Width of proposed bridge.
i. Will the proposed bridge affect existing water flow? ❑Yes []No I Will the proposed bridge affect navigation by reducing or
If yes, explain increasing the existing navigable opening? []Yes []No
If yes, explain
k. Navigation clearance underneath proposed bridge: I. Have you contacted the U.S Coast Guard concerning their
approval? ❑Yes ❑No
If yes, explain:
m. Will the proposed bridge cross wetlands containing no navigable
waters? ❑Yes ❑No
If yes, explain
n. Height of proposed bridge above wetlaryisr.r.G F-D
2. CULVERTS ❑This section not applicable
a. Number of culverts proposed: 2
b Water body in which the culvert is to be placed:
U/T Fulcher Creek
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F-star DCM MP-5 (Bridges and Culverts, Page 2 of 4)
c. Type of culvert (construction material)
Corrugated Aluminum Alloy
d. (i) Will proposed culvert replace an existing bridge?
❑Yes ®No
If yes,
(ii) Length of existing bridge:
(iii) Width of existing bridge:
(iv) Navigation clearance underneath existing bridge:
(v) Will all, or a part of, the existing bridge be removed?
(Explain)
f. Length of proposed culvert: 50'
h. Height of the top of the proposed culvert above the NHW or NWL.
0
j. Will the proposed culvert affect navigation by reducing or
increasing the existing navigable opening? ❑Yes ®No
If yes, explain:
e. (i) Will proposed culvert replace an existing culvert?
®Yes []No
If yes.
(ii) Length of existing culvert(s): 50'
(iii) Width of existing culvert(s): 36"
(iv) Height of the top of the existing culvert above the NHW or
NWL: 0
(v) Will all, or a part of, the existing culvert be removed?
(Explain) All of the existing culvert will be removed
9• Width of proposed culvert: 42"
i. Depth of culvert to be buried below existing bottom contour.
1'
k. Will the proposed culvert affect existing water flow?
❑Yes ®No
If yes, explain:
3. EXCAVATION and FILL [I This section not applicable
a. (i) Will the placement of the proposed bridge or culvert require any
excavation below the NHW or NWL? ®Yes []No
If yes,
(ii) Avg. length of area to be excavated: 10'
(iii) Avg. width of area to be excavated: 20'
(iv) Avg. depth of area to be excavated: 1'
(v) Amount of material to be excavated in cubic yards: 7_5
c. (i) Will the placement of the proposed bridge or culvert require any
high -ground excavation? ®Yes []No
If yes,
(ii) Avg. length of area to be excavated: 40'
(iii) Avg. width of area to be excavated: 30'
(iv) Avg. depth of area to be excavated: 5'
(v) Amount of material to be excavated in cubic yards: 225
b. (i) Will the placement of the proposed bridge or culvert require any
excavation within coastal wetlands/marsh (CW), submerged
aquatic vegetation (SAV), shell bottom (SIR), or other wetlands
(WL)? If any boxes are checked, provide the number of square
feet affected.
OCW 115 ❑SAV ❑SB
❑WL _ ❑None
(ii) Describe the purpose of the excavation in these areas:
Pipe replacement
252-808-2808 :: 1-888-4RCOAST :: www.nccoastalmanagement.net revised: 10,'261'06
Form DCM MP-5 (Bridges and Culverts, Page 3 of 4)
d. If the placement of the bridge or culvert involves any excavation, please complete the following:
(i) Location of the spoil disposal area Excavated material will be reused on site, any leftover will be taken back to maintenance
area.
(ii) Dimensions of the spoil disposal area: N/A
(iii) Do you claim title to the disposal area? ®Yes ❑No (If no, attach a letter granting permission from the owner.)
(iv) Will the disposal area be available for future maintenance? ❑Yes ®No
(v) Does the disposal area include any coastal wetlands/marsh (CW), submerged aquatic vegetation (SAVs), other wetlands (WL), or shell
bottom (SB)?
❑CW ❑SAV OWL ❑SB ®None
If any boxes are checked, give dimensions if different from (n) above.
(vi) Does the disposal area include any area below the NHW or NWL? ? ❑Yes ❑No
If yes, give dimensions if different from (ii) above.
e (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed below NHW or NWL? ❑Yes ®No
If yes,
(ii) Avg length of area to be filled.
(iii) Avg. width of area to be filled
(iv) Purpose of fill.
g. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed on high -ground? ❑Yes ®No
If yes,
(ii) Avg. length of area to be filled:
(iii) Avg. width of area to be filled:
(iv) Purpose of fill:
(i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed within coastal wetlands/marsh (CW), submerged
aquatic vegetation (SAV), shell bottom (SB), or other wetlands
(WL)? If any boxes are checked, provide the number of square
feet affected.
❑CW ❑SAV ❑SB
OWL ®None
(ii) Describe the purpose of the excavation in these areas.
a. Will the proposed project require the relocation of any existing b. Will the proposed project require the construction of any temporary
utility lines? ❑Yes ®No detour structures? ❑Yes ®No
If yes, explain: If yes, explain:
If this portion of the proposed project has already received
approval from local authorities, please attach a copy of the
approval or certification
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IUN 0 8 2
®CM_MHp CITY
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FtX OCNI MP-5 (Bridges and Culverts, Page 4 of 4)
c Will the proposed project require any work channels? d. How will excavated or fill material be kept on site and erosion
❑Yes ®No controlled?
If yes, complete Form DCM-MP-2 Use BMP's
e. What type of construction equipment will be used (for example, f. Will wetlands be crossed in transporting equipment to project site?
dragline, backhoe. or hydraulic dredge)?
❑Yes ®No
Typical roadway construction equipment will be used, If yes, explain steps that will be taken to avoid or minimize
including but not limited to tracked excavators, dump environmental impacts.
trucks, flat bed trucks, back hoes and boom trucks.
g Will the placement of the proposed bridge or culvert require any
shoreline stabilization? ®Yes ❑No
If yes. complete form MP-2, Section 3 for Shoreline
Stabilization only
a�
Date
US 70 at North Harbor Pipe Replacement WBS#2.201611
Protect Name ----- t-1 ---- - -
Z-1--/vr—
Applicant Nam A
Applicant Signature
1
252-608-2808 :: 1-888-4i(Z;OA3T :: www.nccoastalmanagement.net revised: 10/26/06
J
PIPE REPLACEMEN ECEIVED
N US 70 JUN
OVER UIT FUL CHER CREEK
w E CORE CREEK USGS QUAD MAD -MHD C11-y
BOGUE-CORE SOUNDS 0302;?&M
+ WHITE OAK RIVER BASIN
Pipe s WBS ELEMENT NUMBER 2.201611
Replacement MAY 21,2018
North River Corn r
SRi238/-
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■ Complete items 1, 2, and 3.
A. Signature
■ Complete items 1, 2, and 3.
A. Si atu
■ Print your name and address on the reverse
X
Agent
■ Print your name and address on the reverse
X ❑Agent
so that we can return the card to you.
❑ Addressee
so that we can return the card to you.
0 Addressee
B. MName�),.0 to of Delivery
■ Attach this card to the back of the mailpiece,
B eceiv by nted ame) c. eI ■ Attach this card to the back of the mailpiece,
or on the front if space permits.
or on the front if space permits.'r'
D. Is delivery address different from item 1? ❑ Yes
1. Article Addressed to:
D. Is delivery a dress ifferent from item 1? ❑ Y 1 • Article Addressed to:
If YES, enter delivery address below: ❑ No
No
If YES, enter deli7--
I III Il (III
3. ServiceTyPe
❑ Adult lt Signature
❑ Priority sr
❑Registered MailTm
I I IIIII III
3. Service ®
❑ Adult Sign re ❑ R �istyerMeda11al
III I II I II I I I I'll l l III lI i l I I
DeliverySnRe
❑ Certified
Sr
III I II I I II I l i II I II I l l Ill
a
uRAdRestricted leRIstry ail Restricted
rtiryfeM
❑ C
9590 9402 2928 7094 3647 41
❑ Certified Mail Restricted Delivery
El m Receipt or
all ve
❑ ified Mail Return eipt for
❑ Collect on Delivery andse
❑ Collect on Delivery Restricted Delivery ❑ Signature ConfirmationTM
2• p +r. is nn imhar (Transfer from service /aW)
❑ Collect on Wive V Men; dise
❑ Collect on Delivery i l�DgS I tore ConfirmafionTm
2. Article Number (Transfer from service taben I
7015 1520 0001 1559 8734
'Mail
Restricted Dellvery
❑ Signature Confirmation
Restricted Delivery
7 0 Z 5 Z 5 2 0 0 0 01, Z 5 5 9 8 7 2 7^'-
�.a Mail gnature Confirmation
oil Restricted Delivery Restricted Delivery
OMail
Ps Foam 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
RECEIVED
JUN 0 8 ZU"' -�--
DCMA-MAHD CITY