63408_Repalce 50 x 5 2 15 x 5 Docks_20181120

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Previous per�rnit,#
GENERAL--- PERMIT
NeW. -,E]M'odrifi'ciation 'ElCoi-hplete'Reissue 'D Partial Reissue' Date previous perr-hit'issued
'As'authorizedby the State of North Carolina' Dbpartm'-dnt of Environmental Quality
and the Coastal Resources tommission in an area of environmental concern pursuant to 18ANCAC,
�l Rules attached.
Applicant Name i L.L' Project Location: 'County A t. A Lf
Address 2 'F-P AY Y/ i z-::- i:J Street Address/ State Road/ Lot,#(s)'
State i� e- ZIP --Zt-7--d
Phone # E-Mail- 1 Lo=, Subdivision -Y Authorized Agent I A city -2-</ zlp�
0 CW
,KEW
g PTA EIES 0 PTS
Affected
'
AEC(s):
tD OEA '
El HHF
0 1H El UBA 0 N/A
El PWS:
ORW:
yes 1- o
PNA.
yes ono
Phone# River Basifi-J-AE - Pk m 7-1- c7
Adj. Wtr. Body_bill 4 T-1 r,,] A L—) (nat,,(— unkn)
Closest Maj. Wtr. Body W L0 -7Z1 J'§R<
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Agent or Applicant Prin ydme
Signature Please read compliance statement on back of permit
Application Fee(s) .:Check#
Pe gpkOffic P'inted Name
Signatre
Issu'i_ng Date
Expiration Date

October 12, 2018
zG
agree to forgive ray 15 feet Rsght of Way
so William D. Shade can extend his dick
to my property Dine. ���� - 0,g-v--9,�
`U T Arr IGi Ln f

--«(- & &67,-4 - C/o, - 6 3
October 12, 2018
agree to forgive My 15 feed Right of Way
so William D. Slade can extend his dock
to my property Hnes

Applicant: 011., 64-A-919-
Date:
General Permit #.,22 q 2S --
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 Blame
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
anjanticipated
restoration or
ternimpacts)
FINAL Feet
(Anticipated final
disturbance. -
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other ❑
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 ❑