68393_Bulkhead_20171003 (2)

77
JPAIVIA Z,.DREDGE &-FILL 8
GENERAL PERMIT Previous permit # RNew ElModification Dco,mplete Reissue El prp''vious permi Partial Reissue Date t. issued N A
As authorized by the State of North Carolina, Department of Environment and Natural'Resources
and the Coastal Resources Commission in an area of enviecinf-hental.c6ricern pursuant to 15ANCAC,, •oc-
5ERules attached.
Applicant Name'_/ �14 ^14� Project 1_6cation: County, �?:-z -4
Address L &7Q zr--7.4
City LJA Statd "4C_-ZIP 2:-?
Phone (_z' �,2_) q-V#- 5--V- !WE -Mail
Authorized Agent '-) )eT—
Affected
El Cw A EW7 PTA " ES PTS
AEC(s): D OEA 0 HHF. 0 1H KUBA AN/A
El PWS:
ORW: yes / no FINA - yes rno?
Street Add,ressi State -Road/ Lot #(s)
7_'-7
Subdivision
City 1, ZIP 2- <Y W
Phone# River
Adj. Wtr. Body v dZnat) /man /unkn)
Closest Maj. Wtr. Body ;21-Al 141 el e -1 7.;? v L)-e
Type �f Project/ ActiV'iiy �A P Z_A-Z_ E
49 P) 1-f
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MEMO
MEMEMOMMEMEME
MEMMEMEME
HIMEMEMEME■IMME
MEN
MEEMMEMMMENEMEMEMEM■MEMO■
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111MMMEMMMMINEEM
MEN
MMIKEEMENRUNNOMEME
Y
Agent orApplicant Printed Name ,�Z
Signature Please read'cqTp'iance stateen' on back of permit
Y'3
V
Application Fee(s) Check#
Permit bffice'r1s,Rrinted Nam'e','-,'-
'/a
Signature, !
T
Y
lssuffig'Date' �' 'Expiraiibn Date

Appiicarct L7A Permit#: (� 3
g3-
' Date:
Describe heiawthe HABITAT disturbances far the appCcaiian_. Ail values should match the name, and urns of measurement
faurtd in your R-ah t code sheet
TOTAL 5q. Ft
Fjt Ai- Sq_ Ft
- TOTAL Feet
FINAL Feet
(ApPJed far.
(Anfldpated final
(App(ied fart
(Anticipated frW
Habifiaf ]Marne
DISTURB -TYPE
Oisturbance total
disturbance.
Disti�bartce
disturbance.
.'
Chabse One
includes any
Excludes any
total includes '
Exdudes any
anticipated
resfaratiorr
any anticipated
restarafian and/or
restoration or
andlartemp
restoration or
temp impact
temp impacts} •
im oact amount}
temp impacts)
amaunf)
4.r—
Oredge Q ' Fill [I Seth. Q Dater Q
� 1 d
� O 1"► .
61 0 r4o
Qrod4e Q . Fill Q Bath Q Other Q
t 1 O
'
for-r—aM
Ores dge-Q- Fig Q Bath Q Other ❑
Dredge Q ni Q Bath Q Other El
Qtedge 0 Fill Q. Both Cj Cutter Q
'
_ i 2
Drudge Q : tit 1✓4 9a& 0 Other Cr
Dredge Q 3 C_' Sant .l=1 Other Q
1.
Dradde: Q. F.ift Q gotft f=r Othet Q
lum
dgif--Q ;--,K ['. sat ur . Ocher (_i:
(-
t7�age t Full C Elath Q Other.
`—'fescue r Fig Q- Elach Q' Cther ( '
Ore±ic3 I =nl ' tam • t ter
�•
Dredge Q R i Q 3o$t Q Other. Q
I
`
bredge Q . Fill 0 600 Q .. Ocher' Q

September 29, 2017
I agree to the construction of a new bulkhead at 27 Glenhaven Rd West Washington, NC which is
adjacent to my property.
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