68957_Bulkhead_20180723

issue
and the Coastal Re�burc6sCom mission in an area of environmental concern pursuant to 15A NCAC
MLR les attached.
ZU
Applicant Name- Project Location: County
Affected
Closest Maj. Wtr. Body &YMA?cr'
MEN
MEMNON
'' .

ADJACENT RIPARIAN PROPERTY - 0MAER STATEMENT
I hereby certify that I own property adjacent to
17 =1/,_c A D- ' s property located. at -: -
(Name of Property Owner)
(Lot, Block, Road, etc.)
on�1�3i:/�lARkt �fl�DV� , in D . a N.C.
(Waterbody) ( crown and/or County)
He -has described to me, 'as shown below, the development he is
proposing at that location, and, I have no objections to his
proposal.-
-------- = -----------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED -DEVELOPMENT:
(To be filled in by individual proposing dew
<~ /� CarolinaDigestiveDiseases
�,•� 704 W.H. Smith Blvd:
Greenville, NC 27834 j
[phone]
www.cddgastro.com
�t
Signatuke
C r
Print or Type Name
Telephone Number

0

• - _ - - - - - - - -_ - _ _- - _ _ - � - _ _ yam: � �� __ _i�ti3 � �_-�' �'.
AD TACEIT RIPARIAN PROPMEIVY CUBAM STA
t herebv certify that I own property adjacent to
is property located at
yt 5 ga ,Ulf
Sau L.
L , ►�/�, in V V 1�IJ�i� 12 N.C.
on 1- -- ....
ate/or County
(Waterbody)
He.has described to me,'as shown below, the development he is
proposing at that location, and, I have no objections_to his
proposal.
-------------------------------------------
-----------------------
- . __ ___.mot.. .,z nRvMOPMM
Signature
• Print or Type Name
Telephone Number

Applicant: jI &gLCS tj FAO
Date: a 3 - P vY 7_0 / 8
-General Permit #: / Q 9
7_0
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)
J ' LIA1
Dredge ❑ Fill oth ❑ Other ❑
5
bs
,I
S A�(OW A
Dredge ❑ FiBoth [I Other ❑
0T Z
�QF7 2
$Zpu j)
Dredge ❑ Fill ❑ Both ❑ Other
I DSdr%,
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ - Fill ❑ Both ❑ Other 0--
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 ❑