HomeMy WebLinkAbout63844_Charles Reynolds_20180227No.72971 iPAIVIA-JUDREDGE & FILL 'A C D
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-As authbrizE h Carolina,:Department 'd by the of Nc;rt of Environmental Quality
and the it es-ource$,Commission i an -area of environmental concern pursuant to I SA NCAC -
Coastal R I .-
attached.
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ican ame Pro ect Location: County •t
Address,,-'
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Street Address/ State Road/ Lot #(s)_
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,State ZIP
Phone*30 Subdivision' r
DPI n
A7uthorizecl'Agent, City ZIP
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Project-1 Activity 1/7
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A building permit may be required by:
Note Local Planning jurisdiction)
Notes/ Special Conditions
Name
r11—
fly*
Please read compliance statement on back .3,f—permit
Signature'
Application Fee(s) Check#
See note on back �eqr(
River Basin rules.
TJ's Marine
Aitikorized Agent Coissent Agr. eernelit r
herby' authorize Tobin 4Ay l ettcrton
41
Air , LLC to act on my behalf in obtaining LAMA perniits'for '
NC Division of Coastal M
/ Habitat Impact Computer Sheet
Applicant: Date: 2 /a�
General Permit #:
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)
Dredge ❑ Fill ❑ Both ❑ Other
`
r
Dredge ❑ Fill ❑ Both ❑ OtherAr
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 ❑
2 - $-2 'B :: 4-888-4RCOAST wvnemeni.nat revs--,d:02: 1-10