63471_Jonathan Carr_20181212

y;i�• �v
CAMo D •f A • / REDGE&,'FILL
GENERAL PERMIT.'.�
Pre ������ ,,,
: -�
ions' #. .°,
f New ❑Modification " []Complete'Reis'sue',-
.—permit,��.�
❑Partial Reissue Date; previous-pe'rmi :issued' ]'=R ''
As;authorized'by the.State of North Carolina,"'Department:of:Environmental'Quality
_ ^
and, the Coion;i an`aofCommiss_environ e_ ntaconcern 'uastal Resources rea rsuanf•to I'SA NCAC.'�Q�'
'7� - -
licnt'
App.aName "l
•�
Project Location: 'Coup - e(s
ty..' -..
,n,
1 ,�j
Address C7 �G'f lr Street Address/ StateRoad/'Lot.#.(s);: k
r,' City MTh('. State%�L `zIPGd-;
c `�•'
�i� / `f • h ;';
Phone ail
Subdivision
- AutFiorized Agent' T
A
ZIP,
❑P A ❑ ES' ❑ PTS
Affected: cW'Ew, T
Phone # ( ) River,Basin❑
�at
OEA ❑ HHF ❑IH ❑ UBA ❑ N/A'n
AEC(s):`
Adj. Wtr. Body %r man unkn ,
,'0MS
_ • ORW , yes /� PNA• yes / r 0.
Closest Maj. Wtr. Body
1
i r
■■■■■■■■E■■■■M■■
■■■
"MEMO
ism
4°WM■■■■■■_M.
■■►���■�■■■■■■■■■■■■.■��■■■■ram■■■■■■■■■■■■■■■
■��■��■■■■■■■■■r�■
■�i■■■■■■■■■■■■■■■■■■■
MENEM
'■■■NEXT■■■■■■i■■■■■i■■■■■■■■■■■�■ii®■■■WASIM) I WE 011 mad
Ag nt MAp
cant P ; nt
,Signature
PI e i
am e Permit ffi �i's P •into Name '
OA\
is
compliance statement onba kofpermit" Signature
C e& # Issuing Date _ ' ". piration Date'

Authorized Agent ConsentAgreement
herby authorize Tobin Jay Tetterton of
(proPeRy owners))
Trs Marine Construction, LLC to act on my behalf in obtaining CANA permits for
the location Iisted below.
PROPERTY ADDRESS:
PROPERTY OWNER'S MAILING ADDRESS:
-- J,&^ e.<,r-r
l..0
b g
Phone No. CPS' an 29-a
PROPERTY OWNER'S
AUTHORIZED AGENT
DATE: lol Ib 20-L9
W/Authorized Agent Consent Agree.

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)
J'
Dredge ❑ Fill ❑ Both ❑ Other,l
1 /V
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 ❑-