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Home My WebLink About71176A_Kirk Foreman_20180918IXCAMA / ❑ DREDGE & FILL No 71176 CS) B C D GENERAL PERMIT Previous permit# ftNew ❑Modification ❑Complete Reissue ❑Partial Reissue 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 concern pursuant to I SA NCAC N , aU� Rules attached. Applicant Name k, r k Project Location: County Cw v r V j- P� Address \ k'S Nc. v w 51,,; r e R -} City Ay d kt FA State fV 1.. ZIP a�91b Phone # (a S1) > a - 4 % `"S E-Mail Authorized Agent Affected ❑ CW [NEW Do PTA ❑ ES ❑ PTS AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A ❑ PWS: ORW: yes / (fip% PNA yes /Cr:/ Street Address/ State Road/ Lot #(s) Ili Nc, r,,,, Stier c �2d- Subdivision -__" City < } } ZIP Z }mot 16 Phone # ( ) River Basin 6 ,' Adj. Wtr. Body O-vr 4 lC ! ,-I 1A /man /unkn) Closest Maj. Wtr. Body Ow i 4 ` k '--- Type of Project/ Activity i L V 124 02k 1t i (Scale: i 1-1 v ) Pier Fixes Flom Fingi Groi Bulk Bash Boat Boat Bea( Othi Shor SAV Mor Phoi Wain ■��1■■■■■■■■�F�:■■��■ ■■■■■■■■■■■■■C■ .ng Platform(s) ■■'.�� H��ic ��. �i■■■ice■�■��■■�t1■■■■■■l►'■ i length number ■■■■��■■■■■■■■■1�■��■■■■■■■■■■■■■■■■■■■�■■■ avg distance offshore ■■■■�1i■■■■■■■11■��■■C!R'�!!�■■■■■■■■■■■■■■■ max distance offshore ■■■�I■■■■■■■■■��■■■■��■!�!'!+■■■■■■rl��■■■ MMMM1M.MMMMMMMM cubic yards ramp Bulldozing ■■■i,■■■■■■■■■■■■■■■■�■■■■■■■■■■■■■■■' ■a■■ii�i��i�e��iii■ii■■■�i■■■■■■i�i■ii■ ■■■■■RIME■i■ ■■11■1Mt■■■notsure ■■■■■iii��iii■■■ -linel-ength III yes ■■■■�I■■iL�'�■■l1■■I■■■■■■■■■■■■■■■■■■■ torium: yes no 11i1,iAll, ■■■■■■■��■■■■■■� �4i1�■■�■i■■■�■■■��'�r',■ A building permit may be required by: C ( Note Local Planning jurisdiction) Notes/ Special Conditions X 1-w v n o j e n V-, < `_ Agent or Applica t Prime Signature ** Please read compliance statement on back of permit* Application Fee(s) Check # ❑ See note on back regarding River Basin rules. �. V-\4. � c Permit Office ' am - , I �'O 05 �; 1 7-� ignature I ' h i ol>Z j%►�t��o►T Issuing Date Expiration Date NC Division of Coastal Mat. Habitat impact Computer Sheet Applicant: Date: Permit #: -4 `I �-(0'4 Describe belo',-� 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) D Dredge ❑ Fill ❑ Both ❑ Other qO Cp 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 ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ 252-808-2803 :: 1-383-4RCOAST :: www.nccoastalmana9-gment.net revised: 02/03/10 ■ Complete items 1, 2, and 3. ■ 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: LavjS T LAIt � C�, I III' I'I IIIII III i III IIIIIIII'�IIIII 9590 9402 3209 7166 6727 04 9 ArfirlP Mi —har /TranCfar from .CPNirP IahP.II 7015 3430 0000 2882 8432 PS Form 3811, July 2015 PSN 7530-02-000-9053 7 ❑ Agent ❑ Addressee Date of Delivery D. Is delivery address different frorv(jte� 1? ❑ Yes If YES, enter delivery address low: ❑ No 3. Service Type ❑ Adult Signature ❑ Adult Signature Restricted Delivery ❑ Certified Mail(@ El Certified Mail Restricted Delivery ❑ Collect on Delivery ❑ Collect on Delivery Restricted Delivery ed Mail ed Mail Restricted Delivery O Priority Mail ExpressO ❑ Registered MaiITM ❑ Registered Mail Restricted Delivery ❑ Return Receipt for Merchandise ❑ Signature ConfirmationTM ❑ Signature Confirmation Restricted Delivery Domestic Return Receipt ■ Complete items 1, 2, and 3. ■ 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. ArticlQ Addressed to: GC 7 771 IIIII III IIIIIIII I I III I (III 9590 9402 3209 7166 6727 11 9 Artirle Number (Transfer from service label) 7015 3430 0000 2882 8449 Ps Form 3811,, July 2015 PSN 7530-02-000-9053 A. Signature _ X ❑ Agent ❑ Addressee B. Rqpeived by (Printed Name) C. Date of Delivery I4Rvel� %trot D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Priority Mail Expresso ❑ Adult Signature ❑ Registered MaiITM ❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted ❑ Certified Mai10 Delivery ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery 0 Signature ConfirmationTM n 1 cured Mail ❑ Signature Confirmation ured Mail Restricted Delivery Restricted Delivery or $500) Domestic Return Receipt / "a% p L/* E 8 ��, 1b� wflicrr `� Neic✓�97�rct�.✓ W J/.0' > 3 1In 4_A in M F.I.R.M. ZONE "C" N N in 32,948 SQ. FT. M �� 3 22° 40' 20" E •�� 127.63' C. (rod# 1137 ) N' ES R� + I NARROW SHOR + -- I 'J+ ,�- I` 127.61' s1Ps �- dam. rS 32u "lu 63.37' CURR TUCK S 19° 11' 46" E SOUND E� 51�� Aow 25z a SFo" W Q sF 14—Q F.I.R.M. ZONE °C cj io 32,949 S0. FT. / ° N ~ ,i �� S 220 40' 20" E � 127.63 1 � � I C. (6011 # 11,57 1 I N ROW SHORES Fri NAR � 127.Alt 61' CURR TUCK S 190 III 46" E SOUND I� 9f I