72583A_Bridge #23_20190227

,LAMA / 'DREDGE & FILL
GENERAL PERMIT
New ❑Modification Complete Reissue ❑Partial Reissue
No. 72583 A B C D
Previous permit #
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 15A NCAC
❑ Rules attached.
Applicant Name j 4& f
Address )113 Aiuc T m L.i7F 1ct>
City ,G t) rv, r-TviJ Stated ZIP7CK-1Z
Phone # (��) • jf5rjc7E-Mail W
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Authorized Agent 1 avL W,11 LIQM�
Affected ❑ Cw ❑ EW ETA ❑ ES I EdPTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes /L:J
Project Location: County ��',G r
Street Address/ State Road/ Lot #(©©s) 7If CO• F91
,2RUN(a ILp
Subdivision
City COCEIJ ZIP
Phone # ( ) River Basin �w
Adj. Wtr. Body 1lJpM� nat man /unkn)
Closest Maj. Wtr. Body
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P
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i
RIME
•
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i�IBasin,
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
OMEN
MEN
number
Bulkhead/ Riprap length
0
011MILVZ2.
W.
V
5
W,
1
90 121
9
1 JEW
M 1,
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a
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5!
1 U
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avg distance offshore
max distance offshore—
channel
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Agent or Applicant P;XK�7
Signature * Please read compliance statement on back of permit*
Lam' °a w34 1.79P. 1. U17
Application Fee(s) Check #
Permit Officer's Printed Name
C
Signature
Issuing Dkte'— Expiratio ate
i y+,2

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: NC Department of Transportation Permit #: 72583
Date: 02/27/2019
Project: Subaqueous Utility Bore (at
Bertie Bridge #23) Buncomb Rd.
Colerain, Bertie County
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
High Ground
Dredge ❑ Fill ❑ Both ® Other ❑
50
0
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 ❑
282-8 8-28 8 „ 1-888-4RCOA T :, w3nrvv o stalm na epme. t-net revised:02103110

---------------------------------------------
----------------------------------
i DATUM DESCRIPTION
A 510
m
NNE Lau IZED COW I01E SYSTEM DEVELOPED Fal IN IS PRMECT
D
IS BASED ON THE STATE KAE COORDIMIES ESTABLISHED By
MCCS FOR MOW MT 'BER23-2'
L - /1
T =
YIiN xA0 e)IC0RYW SIAIE PLATE 010 COOBIMtES Of
R -
THING: 90I.191.8290 I"I FASTING: 2.642.105.5010 Ifll
SE
ELEVATION: 24.69 Ifll
[A AVERAGE COB I TIED MID F91OR USED ON 1H15 PROTECT
IMND TO 010) IS: 1.000020680
THE N.C. LAMBERT 010 BEAMING AND
LOCKIZED HDRIZOMIAL CA NIMD DISTANCE FROM
'BER23-2' TO -I- STATION 11+57.85 IS
R' V 1114.11'
S SW R' 35
KL LINEAR DIMENSIONS ARE L06KIZE0 HORIZONTK DISTANCES
VERTICK MIIN USED IS MVD 80
V
0
1
P1 Sto 12+67% P1 Sto 16+3701
'(RT) - 3553'l2BIRT1 0 - Tp9 /79"(LT)
T D - IF S706f D: 5'1731-
L - 212%' L - 137D5'
T - 1/0J7 T - 66,6r
R = 340DO' R - 000LICY
SE 004 FT/FT SE - OD4 FT/FT
RO SEE PLANS RO - SEE PLANS
+
15+00
O Nqo 4y,
B3
SOB IT 315YAON5.A l
SIC,CAASf
178PJR66
4
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E PLANS
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MEMORANDUM
TO: Melissa Sebastian, Accounts Payable Clerk, Morehead City
FROM: Greg Daisey, DOT Project Field Representative, Elizabeth City
DATE: 2/27/2019
SUBJECT: Debit to NCDOT's Account for a CAMA Permit
Please debit DOT's account in the amount of 400 for the following CAMA
permit request:
Project: Subaqueous utility bore under Chinkapin Swamp on Buncomb Rd.
(SR 1328) in Colerain. Utility will be adjacent to Bertie County Bridge
#23.
County: Bertie
Transportation Improvement Project (TIP) No.: N/A
WBS Element No.: 17BP.1.R.66
General Permit No.: 72583
Major Permit: N/A
Fee Division
DCM: (100%)
DWQ: (0%)
Please contact our office if you need further information.
Thank you.
Cc: Ella Godfrey