63081_ Natural gas Line under Cherry Run._20180808

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­PERMIT',.�- Previou's perm'it'#
New ',,El Modification- ❑Complete Reissue El Partial Reissue Date previous permit 'I t is "sued A -
As authorized by the State of North Carolina, Department ofAhWonmental Quality
and the Coastal Resources Commission In an,areaof environmental concern pursuant to 15A,NCAC
Applicant Narneee, t:>*hj�-1 i-n4A
Address
City 1\ 13a4 t-1 State W.'(_,ZIP a,
Phone # (ZS-)5771, E-Mail
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AuthorizedAgent N1 i A
L11CW Ll EW, -1 ES
Affected PTA E El PTS,
AEC(s): 0 OEA 0 HHF D . I . H D,UBA El N/A
0 PWS:
ORW: yes /(D. PNA yes k nog
I/
;Zmyle - s attached.
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Project Location' CountyC—
_
Street Address/'State Road/ Lot #(s) cyr I- uj `2
Subdivision A— %
City w 1-J 25P
Phone#-,,(, River BasirrrZ'122 - PA In', i ors
Adj. Wtr.'Bod � -Fo, c�g 'Iman'/unknJ'
Closest Maj. Wtr. Body -F7AM 4_w&;) 21 v
Type of Project/ Activity '4, —T
ENE
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--,'Agent or Applicant Printed Name
',Sig nature "Please read corhpliance statement on back of permit"
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`ApplicationFee(s) Check#
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�r.I afi �-er'� Printed Name
Signa , tuPer­�-�
Issuing Date Expiration"' Date

Applicant: �ip-9Ntas.1-' A-'�'uTzA-L A- S
Date:
-General Permit
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
DISTURB TYPE
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
L
Dredge ❑ Fill ❑ Both ❑ Other ❑
2
1 QOp Tr T
2
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 ❑