71283A_Nancy Morgan_20181114

�;kCAMA / DREDGE & FILL N2 712836
g C DV
GENERAL PERMIT Previous permit#
New —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 15A NCAC
Rules attached.
Applicant Name�AAd A /' 1112W6,1 IV
Address
City Eh 1 Il State NC zip Q 7 �, Z
Phone #) '�33- 2- E-Mail
Authorized Agent
Affected ❑ CW pEW A PTA ; ES ❑ PTS
ElOEA ElHHF ElIH ❑ UBA ElN/A
AEC(s):
❑ PWS:
ORW: yes /ifq.' PNA yes /?110�)
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City 6041U Joe z I P z 7�32
Phone # (M2) D River Basin
Adj. Wtr. Bod,Iman /unkn)
Closest Maj. Wtr. Body
i
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
NNE■■■■■E■EEE■■
MEN
■■■■■■:■■■■■■®E■EEEE■
M. -
■■■■■■■■■■■■■■■■■■■■■■■■■■■■rn■r!■■■■■■
��®■■■■■■■
■■■■■N"Ei■■�■■��■■■■�■■■■Ens
■■■---=---`_
�■■INS'11�II�S�ri►r.:�■�:i■��I������
-■�iiL'S':!!!.■■■%■■`iu■L,�in'ri,� �1�■1��■■■lir�l!■■■(L'�Til■■■■
- - � �:77riJ�l,■■■■■■►/fi���lJ2lG'►�':iilf�7�1.1!a"7■�1�■■■■■■■■■■■
MWANNOW MEN INNEERNEEMEM NEON
Aqenf 4r Ap licant Print d Name 'L
lignat re Please read compliance jstate ' nt on back of permit �*
Application Fee(s) Check #

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT ( O Sl�
I hereby certify that I own property adjacent to a I, c L, ' , Maw-,, s
(Name f Property Ap licant)
property located at 6 1 Z .S�'r�{ _S f � (� r
1 (Applicant's Address, Lot, lock, Road, etc.)
on Iblrn1tr(L 50� in �'-deP�•, e/10W4,x , N.C.
(Adjacent Waterbody) (City/To n and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locati
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) (Adjacent Property Owner Information)
Signalure S,ignatur *
Print or Tye Name P� lea 'it or.�Ty,ppe N me
&/ 2- Si,Lrts i d� 17r :y --cI aW� 17v'►✓C�
Mailing Address Mill g Address
City/State/Zip City/State/Zip t
C1`E- -1lsx-
Telephone Number/email address �ko`a C`'M Teepphone Number/email address
It Iel
�ll `6
Date Date *
(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 /VGt.Y1 l h N 0
(Name, f Property
�1 C�
f r- s
plicant)
property located at (p/ Z \jCi r 1,5 lac /)►'
,/► L _ / < (Applicant' j ddress,� o , Block, Road, etc.)
on /� 1 Tomade-yDuro-c/ _,in c�i n � o w
(Adjacent Waterbody) (C' y/Town and/or County)
N.C.
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) (Adjacent Pr perty Owner Information)
Signat re J Signature
CiOC Aid awl-rrt�S�ic<
Print or Typ6 Aam Print or Type lNya��,,e
�dzf1
Ma' 'n Address Ma' 'ng Address
Ma ling .) /VC a793 Al<� 3
City/State/Z Citt I tate/Zip
A5 � 333 O�'�� 17cr- >►�,�; t,,�/l�yp ` )? '34, a ��y `f
Telephone Num er/email addr s Telephone Number/email address
I-y- ig
Date Date *
(Revised Feb 2017) *Form is valid for one calendar year after signature*

1-1
0

NC Division of Coastal Mot. Habitat imp -act Couvipa:;ter Shaet
Applicant: �C (✓ %'U��iyZ�f�/li Permit #: 7/ zg:
Date: / /
Ail IV, znr6
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 a�arne
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
5 r'rl r u 41?
Dredge ❑ Fill ❑ Both ❑ Other
5
Dredge ❑ Fill ( Both ❑ Other ❑
Dredge El Fill Both El 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 ❑
252-806-2808 :: 1-388 4RCOAST :: +n ww.nrp sa�ast ana!gLqro'snt.net reviswd: '�2/03fH0