71150_David Magnus_20180821

CAMA / - DREDGE & FILL
GENE_ RAL PERMIT
[]New Modification ❑Complete Reissue ❑Partial Reissue
B C D
Previous permit #
Date previous permit issued
No71150
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 03 H. • ((UG
Rules attached.
Applicant Name ,�1►/► I) �� it G 1\1 US
Address �-(y? %z caC 1yl) 'S) � .
State NC- ZIP
Phone # ( 1s1 1 — a E-Mail
Authorized Agent I/r%( C (�
Affected ❑ CW XEW *PTA )rfES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS:
ORW: yes no — " PNA yes
Type of Project/ Activity T31 L PH-ey) Iet )
Project Location: County- (-- A -A AiA tj
Street Address/ State Road/ Lot7�#(s) Sajv 1)
Subdivision
City ZIP��7Z
Phone # �j �) 617 Y7S8 River Basin �Q��CI{-�� —1/4 k
Adj. Wtr. BodyA4�E Vi A7LtJ! � ( ,a ` man /unkn)
Closest Maj. Wtr. Body so)�Jeq
(Scale: )
Pier
Fixed
Float
Finge
Groi
B
Basin
Boat
Boat
Beac
Oth
Shor
SAV:
Mo
Phot
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.21
NIMMEMM
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Length
not sure
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yes �.
6) yes n
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MEN
Waiv _ :
A building permit may be re red by: VT � ❑ See note on back regarding River Basin rules.
( Note Local Planning Jurisdictiuion)
Notes/ Special Conditions
Agent or A plicant Printed Name �
Signal ** Pleas read compliance statement on back of �permit"
C�� ►[ trom=
Application Fee(s) Check #
Permit Officer's Printed Name
1Y1.IA, MA-VAt(
Signature
Issuing Date ExpiratioA Date

NC Division of Coastal Mkt, Habitat impact Computer ShOet
Applicant: i) '�`// D 124 AG Alu5 Permit #: 7 it S-ZW
Date: ATtzP 2 r / wig
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)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
S H& 6ZtA.l6
Dredge ❑ Fill ❑ Both ❑ Other ❑
J
u
Dredge ❑ Fill 4Both ❑ Other ❑
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ur�at.�
Dredge ❑ Fill El Both ❑ Other
3 sr
3, 6od 'SF
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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David and Yvonne Magnus
1234 Sound Shore Drive
Edenton
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