63322_Pier, platform_20181025

[YCAMA / ❑ DREDGE & FILL �i rim No. -724W
1/0 GENERAL,--. PERMIT--' ,174 r- Previous permit
` XNew OModificatio.n ❑Complete Reissue _ ❑Partial Reissue Date.previous permit issued
` As authorized, by the State of North 'Carolina, Department of Environmental Quality
;and the Coastal Resources Commission in an area of,environmental concern pursuant to I SA NCAC�" '�•
Ruld/attached.
-
Applicant,Name I G1 v 1 �'�SG�✓ Project Location:, County ..G�//
Address ag!7 , " �,i,�Cri_ �/l �6ii�� Street Address/ State Road/ Lot'#%(s)
N; •City // O//? / State V�L..ZIP,o�
Phone #�) Sly lJ -Mail.: Subdivision
Authorized AgentCity' ZIP.
❑ CWEW PTA p ES ElPTS . " Phone # • ( ) • River Basin G /'
Affected "El OEA ❑ HHF ❑ IH ❑, UBA ❑ N/A
` AEC(s)-. Adj. Wtr. Body //!/1�! /lC] �� �`f (nat /man /unk ,
❑ PWS ,p
ORW yes / o PNA yes / o . Closest Maj. Wtr. Body,%, ry► ��%% !�
Type of Project/ Activity -14,9 4 Le IVZr r f /de, �'� �r� 1 l ax SOU ✓%
2 (Scale: /
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Fing
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A building permit may be required by: 4&1y/,f
( Note Local Planning Jurisdiction)
p
Notes/ S ecial,Conditions
Agent o5;Applic t Printed Name' Permits
- Signature' Please read compliance state ent on back of permit �Signat�
'.ApplicationFee(s)- Check# Issuing
See note on back regarding River Basin rules:
Expiration Date ,

Name of Property Owner Requesting Pemmt Ta6k- Lmexsom
MaTmg Address: *F=•all �� JS`
u dYl7. �jC
Phone Number_ 2.- �"0 — 0�5' Z
Email Address:
t mortify that i have authorized xiof�t - _
Agatroanbactor
to act on my behalf, for the purpose of applying for and obtaining all CTAMA permits
necessary forfhe following proposed development: R'-Oul.0 Cymt
i
at my property-locaied at aas 614jaz miica -etch lCdk 11.0-or-1 m
in _ n� County.
f furthermore ceffy that f am authorized to gra4 and do in Fact grant permission to
Division of Coastal Management staff, Me Local Permit Officer and their agents to enter
on the aforemenironed farads ar_connection WO evaluahng inbrmagm related to this
permit application.
Property7f!
rfonriation: '
,,
- �r
A z- xi
PAirrforTvm Name
owe('
--Id 1 ; 1
Daft
( 1Po This certfic ation is valid through 22 / 1 `f

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
r-
Applicant : �Gj/YIG�.�®mil
Date: p`e5 216?6P
General Permit #:a LI1I"/
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
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.nccoastalmana9ernent.net revised:02103/10