63481_Gary Cardwell_20181113

.f,. CAM^LDD'REDGE�A_FILL, �� � NO:. -7Z4S6
,. " GENERALj` :PERMIT ?�# �p31-%$1 Previous permit # .�� C D
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ew: - L Modific'ation,, OCom'plete Reissue ❑Partial Reissue Date:previous permit issued AI /� ' '
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As authorizedby the State7of1North Carolina, Department -of Environmental Quality -
and the Coastal Resources ,Commission in :an area of envirohmental concern pursuant to 15A NCAC Q -1-1 ��oc
Wules attached::..
Applicant Npame- �'A� CAi2 , 1'cGL G(t InlLt_ Project Location: County 1..1/5li
Street Address/, -State Road/.Lot'#(s)
City &0I' - State zIP`
Phone #. (,T) . V [T b J S( E=Mail. Subdiviission 12, C1" I�A/J ids
_'`Authorized Agent ZIP
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.-Affected ' •
❑ OEA ❑ HHF ❑ IH ❑ UBA " ❑ N/A
Adj. Wtr. Body - i«' S DUB Oat)man unkn
eyes / no' PNA yes
Closest Maj. Wtr. Body L�� ,2
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AgentorA ' cant,Pri ed'�e
f11.,: ignature P aseread-compliancestatementon•backofpermit"
Application Fee(s)� Check #
t���I�1 � nor • • -
PermitOfficer's .rinted Name
Signature
13 A)OV Zo-1 `s 2U �_5/? "O/�.
Issuing Date Expiration Date,-

Applicant: A 0Y CA1ZD Li U L
Date: 13 A300 z ig
-General Permit M 72- YS6 _ 6
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
J
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 ❑ Fil Both ❑ Other ❑
2 rT Z
Zs� o FT Z
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 ❑