63425_Robin Tharingoton_20181206

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GENERAL PERMIT Previous Permit#4 W_
NeW_'Modification -Ot6m'plei6''Rbissu'e',EPartial Reissu
e Date p'reiouspqrni6ssd6d 'A§'aUth6riz6d by thb,St North Caro.liPa;.Departillent of Environmental Quality
a4the'-'Coastal-RetoUrces Commission in an area of environmental concern pursuant to I 5A NCAC
ORules atta(ched.`
Applicant, Name Project' Location: County,'
Address Street Address/ State Road/ Lot #(s) city 6// State�C -ZIP Zo
lAgI
-.Phone Z"�>
\Subdivisiorl'
Mail.
-Authorized Agent ZIP
Affected L1 CW -XOVY /PTA El ES El PTS- Phone # River Basin''
D OEA 0'HH F 01H 0 UBA El N/A
-AEC(s):, Adj. Wtr. body A� Afie 10�4 i rat man unkn
D.PWS:
Closest Maj.'vVtr. Body.
61RW:', yes �NA- yes
Type of Peoject/ Activity
Y
(Scile:/�_
V
Pier
Fixe
Float
Fing
G '
roi
.Bulkh
Bash
Boat
Boat
Beac
Othf
Shor
SAM
Morg
Phot
Waiv
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fleng th
num.ber'
MEMEMEMEMEM
MEMMEMEM■NONE
ead/ Ripri�p 1e'ngth
avg*distance offshore__'M=1MwVJ
MMMMMMMMMMMMMMM
I
max distance offshore--,
BOOM
immoommom
L
r
channel
MMMMIMMMMMMMMMM
cubic yards
ramp
louse/ Boatlift
MENNEN
MMMMENIMMEN■ME1IM
ME
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NNEMENINMEMMME
HEMMEMME
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0
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Lline Length. .7-20
not sure yes
MWERAMINNIMMENIMMMENNOMMENNOMM
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orium: Wa yes
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MEMIMMENA
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A building permit may be required by:
Note Local Plan-n'ingjuri'sdiction)
Notes/ Special *Conditions
.Sigiiature di Please read compliance statement on back of permit
.
' -AP b_1i6.aiionFee(s), Check#
El See note On back regarding River Basin rules.
Signature
J'; �YG I -,
Issuing Date "Expiration Date'
IF

Authorked Agent Consent Agreement
-Tf-lA(Z11:' +d r To d _, herby authorize Tobin Jay Tetterton of
(Properly Owaer(s) )
TJ's Marine Construction, LLC to act on my behalf in obtaining CAMA permits for
the location listed below.
PROPERTY ADDRESS:
J g� g 040 PA Az-11- f i MAO AD W b i
PROPERTY OWNER'S MAILING ADDRESS:
jcJ��Giz'lj 09.
10 5 Ff ku 6 de-
Phone No.
PROPERTY OWNER'S SIGNATURE:
AUTHORIZED AGENT SIGNATURE:
OBIN TE TTlkRTON
DATE-/::? ----5
20
WAutborixed Agent Consent Agree.

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant:
Date: 6
General Permit #: 7�� (�
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
ternimpacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
t"WA"4�
Dredge ❑ Fill ❑ Both ❑ Other b
Dredge ❑ Fill ❑ Both ❑ Other
(yr�
-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 0 Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-411COAST :: www.nccoastaimanagement.net revised: 02/03/10