71201_Mary & Mike Wolfe_20181001

-. AfC' AN4A / [ `DREDGE & FILL N2 71201 A B C D
GENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue El 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
Rules attached.
Applicant Name Project Location: County C rtzu� r1�V
Address ju Z 144N 1 ► 5 (,ULAJ I+ ti 1 Street Address/ State Road/ Lot #(s)
City lt�)c s101 1. State ZIP S 6 - 11c14ry ( A)Lzw hen t" 7
Phone # ( )_�5:9, f E-Mail Subdivision
Authorized Agent
Affected ❑ CW k EW k PTA X ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes r2o PNA yes /
City L,LW JZ ZIP Z 2? -
Phone # ( ) ')AMC- River Basin f 5r3 LI:j?NK
Adj. Wtr. Body &i j C nat man /unkn)
C'InsPst Mai_ Wtr Rndv 501/ti�
Type of Project/ Activity 4, 1
MEN
MEME
in length
number
ME
avg distance
ONE
max distance offshore q'
cubic yards
ramp
MEMO
h Bulldozing
• -
MEMMINEZ&
Arc.,
offshore
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■■■■■■■■■
■■ar��n■�■`din■�i�■■■■■■■i■
■■'�
■■■■■■■■■■
■■
raw.■
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C��1 Agent or Applicant Printed Nam
Signatu a Please read compliance statement on back of permit"
dU
Application Fee(s) Check #
Perm
Officer's PrintN ed �
Signature
Issuing Date Expiration Date

NC Divasion rif Coastal Mgt. Habitat impact con" p ter 8 ip-eq
Applicant: k-L- I A'k J w�' , ^�o, E- Permit #: 7 (Z Q t /A
Date: *cm-09- 1 Zcl o
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
U" Nl:
Dredge ❑ Fill ❑ Both ❑ Other ff
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`%4AIUk 64jt144
Dredge ❑ Fillj� Both ❑ Other ❑
(9AZUq,y)
Dredge ❑ Fill ❑ Both ❑ Other
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3S?jsiz
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 ❑
252-808-2808 :: 't-M-4RCOAST n w.ncspastalmana�rdLaet revised- 021031,�0�

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to jil�i k, cbI� 's
/� ( ame OfP�operty Applicant)
property located at / ©vZ TR�r n i 10 i- lLCal
,� (Applicant's Address, Lot, Block, Road, etc.)
on ��? in ( 0420a. N.C.
(Adjacent Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatiop.
� I have no objection to this proposal.
I have objections to this proposal.
You can mail any objections to 401 S. Griffin St., Suite 300 Elizabeth City, NC 27909
If you have any questions you can call: 252-264-3901
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
(Property Owner Information)
Si nature
gre
Print or ty e Name ��
tr ri i �1 ao TD in %- PC)
(Adjacent Property Owner Information)
Maih g Address Mailing Address
City/State/Zip City/State/Zi
?1Qy -9373 �rpq AVY -
Telephone Number/email address Telephone Number/email address
Date (4 oUho6k , CX,1Date *
(Revised Feb 2017) *Form is valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at
on
rbody)
(Applicant's Address, Lot, Block`,'Road, etc.)
in
(City/Town and/or County)
C Q 793,-.2,
The applicant has described to me, as shown below, the development proposed at the above
location
I have no objection to this proposal.
I have objections to this proposal.
You can mail any objections to 401 S. Griffin St., Suite 300 Elizabeth City, NC 27909
If you have any questions you can call: 252-264-3901
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
(Property Owner Information)
Signa re
1
Print of Type Name
Mailing Address
Pic 63 V1q a
t-1Fv7,State1ZiD
Telephone Number / email address
?-1�y
Date
j-rY,tr►-y con-)
off rt
wn formation)
"
Ub„�N v
Print or type Name
I.
Mailin Address
Crt tate/Zip
Telephone Number/email address
Date *
(Revised Feb 2017) *Form is valid for one calendar year after signature*

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