63148_Propose to construt 5 x 96 pier with 16 x 16 platform and 3 x 36 finger pier_20180925

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GENERAL "'PERMIT ��o Preivious, peirrnit #;w
R rt Date previous permit issued
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As authorized by,th6 Statb'6(N'ort'h,CaroIind, Department of Environmental Quality
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-and,ihe,Co'a_staI - 'kes6urces domm'ission in `an area 6fenvironrpentalc9ricern pursuant to I SA NCAC
s att4aed.
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Signature.' "'Please read compliance
Permit gfflcq P) intpd-NaMe /V
ant on bac)(of permit** Signature
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Check'#,..�'-`' Issuing Date V E4ration Date

B. F. Warren & Sons, Inc.
180 Taylor Farm Road, Belhaven NC 27810
Office [phone] Fax [phone]
Forrest cell [phone] Freddy cell [phone]
NC General Contractor License #72600
www.ncpiers.com
Authorized Agent Consent Agreement
To: State of North Carolina Department or Local Government Department
from whom this permit is being applied for.
I, the undersigned property owner, do hereby authorize B.F. Warren & Sons INC. to act on my behalf in
obtaining the necessary permits for the below listed projects. I have contracted there services to perform
the work permitted. This agreement is limited only to the specific activity of obtaining permits for the
below specified projects.
Projects:
Replace pier
Project location/ address:
495 Pungo Shores Rd
Belhaven NC
Body of Water:
Pungo River
Property Owner Mailing Address:
Al Reason
4005 Cherokee Rd
Wilson NC
[phone]
Property Owner's Signature:
Authorized Agent Signature: Date:

NC Division
of^Coastal Mgt. Habitat Impact Computer Sheet
Applicant:
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 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
Dredge ❑ Fill ❑ Both ❑ Other,
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Dredge ❑ Fill ❑ Both ❑ Other
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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 :: 1-888-4RCOAST :: www.nccoastalmanagement.net revised: 02/03/10