63152_Propose to replace a 5 x 160 pier and a 16 x 16 T-head platform_20180928

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DREDGE 'FILL
XdAMA' El PGE4
/p(GnCG q. C D,
GENERAL PERM
P rev
ious permit
" '
'&dw-I-'EIM8difiicatiq­n•' Eldoini"O'lete'Reissu6' DPartialRdissue Date previous permii issued,
:As authorized by
State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
211u] �ed
Project Location: County­
Applicarit Name 6-*', �.�er, C
Add 4&-4. Street Aciclr'bss/ State Road/ Lot #
77
City
State4 20A
Phoneii '3E-Mail Subdivision
Authorized Agent CityCity<^ ZIP
-1 CW DEW El PTA,- D ES 0 PTS Phone # River.'Basin
Affected E NIA UBA O El IF ❑ N El El
AEC�(s): OEA 0 HHAdj. Wtr. Body (n��
El PWS: /iman lunknj'
ORW:­ yes / rho PNA yes/ no
Closest Maj. Win Body AZIOA"
Tipe- of Project/ Act ivi
ME ■■■■■..........�.■.■■..■■■....■.......■.
Akent or PRI,P ant Pri7ed Nr-
g_
Signature Phef ad compliance staternept on back of permit
Application Fees) Check#
Narhe
/�
Date

Authorized Agent Consent Agreement
I(j# j, 1Q %/%� J.��/t�� , hereby authorize PAW)r 1t iPh.I.M�✓to act on
(Property Owner) (Authorized Agent)
my behalf in obtaining CAIVIA permits for the location listed below. This agency
authorization is limited to the specific activities described above.
Property Address:
Property --Owner's Mailing Address and Phone Number:.
OVAL A/ 4. /,672,65.
Property Owner's
Authorized Agent
Date: ���y2 ,Y- v? /-/dr
Form: Authorized Agent Agreement as developed by NCDCM revised 7/29/09

NC Division of Coastal Mgt.
Applicant: �rk� "'"kVA- °4
Date,
General' Permit #: ?-A 44�sri3
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 W
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.nccoastalmanagement.net revised: 02/03/10