63845_Eugene Robinett_20190212

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` k CAMA / DREDGE & F.ILL. i„i6lf? _No.'•.-7- 966
GENERAL->PERM.IT' _ ���� .. , ,..'
, . ',' ' .. ' .. -, � •Previous permit,#-
Clew: - • ❑Modjfcation OComplete Reissue ',: ,Partial Reissue' Date.previous permit issued
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.As"authorf26d by the State.of'North Carolina;'DePartrient'cf Environmental Quality \ .
and the Coastal Resources Commission fin,an area of eUvir?nrnOqtaJ concern pursuant to 15A'NGAC
P611 les attached. ,
Applicant Name j f - Project L'ocatiori: • County/ '
Address � S '�� f'/f�J i/'//S �i' i G _. Street Address/'State Road/ L t #(s)
' City /!� �- State 1+ ZIP -
Phone# __. Subdivisi� ,e %
Authorized Agent/ City = 4 ZIP
❑ CW XEW PTA [ S ��P,TS Phone # (' ) ' er'Basin
Affected Ri7
AEC(s): ❑ OEA ❑ HHF ❑ N ❑ UBA ❑ N/A Adj. Wtr. Body % G��
❑ PWS. na man unkn
Closest Maj. Wtr Body ����� Z� -- 'i
ORW: yes / PNA yes / P ��'
e of Project/ Activity
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Application Fee(s) Check #

C Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant22 ,� /1?,rV
Date: � O� /�7 e—LI
General Permit #: d, g 4
Describe below the HABITAT disturbances for the application. All values should match the name; and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts)
amount)
Dredge L, Fill.P.Q, Both ;X 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 0 Other ❑
252- 08-2308 :. 1- 8-4RCO=°ST .. xis rapx.ncgopstalma a a a s,rx c revised: 02f,'03,10