63153_Propose to repalce stom damgage peir and fill in yard_20180928

_ f�CAMA /.E] DREDGE'`& FILL'- •' �!/• �� 7, 44 : j� - •
ENUML PERMIT o
-Previous permit,#_24%
-❑Modification ❑Complete Reissue` '• ❑Partial Reissue Date previous "permit iy
`-• . As authorized by the State of North Carolina, Department of Environmental Quality;.:
- and the Coastal Resources Commission in an-area�of env'ronmenta_I concern pursuant to 15A`NCAC�/`�Rt'`�
p r, ti •..
w_ Miles attached.
' - Applicant Name /Gf Project Location:' County
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❑ OEA
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❑ IH ❑ UBA ❑ N/A
' ORW: ,. yes / no
PNA
yes
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Agent or Appli nt Printed Named _
-Signature Please read compliance statement on back of permit t*
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Application Fee(s) Check #
PerIOffci er-'s Printed_Name
Signature
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Issuing Date Exdatioh Date
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NC Division of Coasta
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Applicant: �� re
Date:�G�j�t �
General Permit #: 'A—1
Habitat Impact Computer Sheet
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 A,
A�5_c>
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 ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastalmanaaement.net revised:02/03/10