63112_Pier, Platform_20180818

ElMA —A DREDGE &FILL ", D-�C No. 12415
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GENERAL PERMIT' Previous' permit_C.1 D
'
-e -/V
XNew OMo8ification El Complete Reissue E10aritiall Reim Date permit�istt issued
As authoHzed by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area f,environmental concern pursuant to i 5A NCAC
^XRules attached.
1111144
Applicant Name Project Location: -County
Ad . dress
Street Address/ State Road/ Lo. #(s)
t,
City
Statezip /
Phone #'9--Q
-Mail
Subdivision
Authorized Agent
City
ZIP
C--]-Cw
Affected
EW
XPTA'
OES -OPTS
Phone # River Basin'
0 OEA
AEC(s):
El HHF
El 1H
El UBA 0 N/A
Adj. Wtr. Body
nat /man /unkn)
0 PWS:
ORW: yes r3�,l
: PNA
yes
Closest Maj. Wtr. Body—
e of Proje t/ Activi Al,�We52P C
51
/C
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Agent or Applicant Printed Name
Signature `f*T[Asp yeajjompljance statement on back ofjpprm
issuing L)ate t:xpiration Liate

;Certify that I oP adj t to
I here , � (»�/1
(Town andfar county)
the development
,ngcd atthe
The applicant has described d.Swnnd � MY COBS'T " o f n man access mess
above location. I un ce of fifteen feet (I$') from my
back a minimmn dish
waived by me-
oii action to the project as proposed but do. not wish to waive the
I have no ]
--- (IS,) setback requirement
- proposed and do wish to waive the (IS')
I have no ob}ed3on to the project as
' setback requirement
I objeot to the p cject as proposed-
LNG OF p�gQpOSF.D DEVEIOPMEi�If
fl1Y ANID/O MAW -MC' devdWmeut)
i?ES individual proposing
(To be filled in by
FE c
4-or type name � r�P-G�•
Telephone numb r
MAW-, d
•JI f t "
Date

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NC Division of Coastal Mgt. Habitat Impact Computer Sheet.
Applicant- �!^�,�//f✓�'/��/`�i5
Date: �p�//f�`I ; , Fp
General Permit#:ate
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 impa s)
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
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 :: 1-888-4RCOAS'T :: www.nccoastaimanagement.net revised:02/03/10