63156_Propose to replace pier wand platform_20181011

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As authorized by the State of North Carolina, Department of'Environmental Quality
&' and the Coastal Resources;Commiss'bn in an area of environmental concern pursuant to I SA NCAC
.: 1es a ched.
Applicant Name Project Location: County
Address'' J' ' �S - �T6i , n /�R/ �iff - Street ddress/ State Roa /,. #(s).
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A building'permit may be required by: _
Note Local Planning jurisdiction)
-Notes/ Special Conditions
Y,
,Agent or App ican Prf ted Name
Signature s/` Please read compliance stat
�` "'Application Feels) , -, '
See not on ba k regarding River Basin rules.
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Date, EVfratio'nbate

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
5
Applicant:/'j
Date: 16 09 fC- �)"q
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 TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impactsimpactsi
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
eq
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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