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Home My WebLink About62278_Maintance Excavation_20171025A 9)REDGE -&FILL 7y' 0 '" ' M EL PERMIT Previous viouspermit # -A D 1VNew _`EM6difdkionEC'oReissue. EPartial Reissue Daieprqvious,permitissued 7. authorized by ih'� Siate`of'Nor.th,C4rolifiaj,Dppirtment of Environment and III Resources - "n , ial concern pursuant to . 15A a t e C6astal-Res'oLirces,Coni'�nission in an area enV!romena a NcAc.07P,)ftz0 I, C41-k-lino. Z111616s"attached. AppilicaintNa'meAt-'- I)OD1 TEL :'J?130VC1r) '(61AM 1551 Project Loi:aiion: County,—rY1ZR lJ C o ('60 AN-1 A '170 .'A Street Addrias State �dcl�es�- oad/ Lot:#( State C zip 2,71� -L City r" V, �4 Thone'#' 6 JOS Subdivision T��,A3 Al\)-rA P 01 E-Mail Authorized Agent -MVII IC61 C rL Affected El CW -, DEW XPjA YES >(PTS -AEC(s)','-" E160A. 0. kHF El IIH El UBA 0 N/A El PWS: ORW:yes I rn� PlJ yes ICn,) o— , City DC-r-" IAIVDfA)(, Rd, ZIP,/ 70/ z Phone# River Basin _P/-,)S Qu 6t A"/ Adj. Wtr. Body Al-1-I&A011 (nnat, man %unkn Closest Maj. Win Body r M E ALL I(. A rOtl K/U INEEMENEEMENNEEN ■■■■i°°■ii■iiii■■ei■■■eON M MOMMEM IMME1101REMMEMEMEMEMME MEIN EMOMMEWTMIL ■■■■■c...■■■■■�.,■�■..L�� ON MMMMU EMENNEWMEMEEMMIKE ME MNMMMMNMMME w EN ENE w 0 ENE ■■1e■■ . . . . . . . . . . . . '�Y split EJ -—w— F-1� FJ rl Y r PerrnitOfficer',s',Printed Name1' Agent licant,Printed Name,' -ef............ . . . Signature !*! Please ce n read�con� ia'' state`milb e�i�n �ck8f'�d'r" Signature pl. goc�o 7 Check*' Is suing ink Date. Applicant: Nor,14 CARoc. J" Date:'; 5- Ocr Zot? General Permit M 6g9 ji 3 - wl(.pGtF� izEs�t►acEs co�l�,s�ro� 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 blame 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) u e a M Dredge Fill ❑ Both ❑ Other ❑ I� ODD F j 1S,o°ofT'' tt.etj Dredge ❑ Fill VF Both ❑ Other ❑ 126FT z I Zd FT'' 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 ❑ 1 FT, 1 FTS]LT' 18 INCHES, 4 IN SILT -1.8 INCHES', 4 IN SILT 3F 4 FT 4 FT4 FT 0 5 FT 5 FT 5 FT