63604_Stephen J. Milkovik_20190114

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tNtRAL PERMIT Previous permit:,--#.., c' : p
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'' EC.pcnpiete,.Rei*e:::::p6rtial-Reissue -1- . . :: . 6ate previous perrnitilssued-,/:::,?/(9:7<f'....,,.;.i :.'":-.',.'''-:c,",••
'.55.1';t1-9ried by the State of North Carglini:Oppariment:ofiEnvironMentilQUaliiy. - • ' • , • : -•'''•,:‘• // .1) .:-:-H'
• and the Coastal Resources Commission in an area of environmental concern pursuant to ISA WCAC,,•, ' „:1.-:•::-!:/.: --,/--S. :5•-: .,-:- , •''s,• - ''':,.>. •-.,-.._.'-,..
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• Applicant Name:- r 47,, :::(--7 ,737-, ;'AV/I.( ."a/,' C -'. , - Project Location County : ;- Z.." 0, .('.,-,--r , - , :.„., ;,::,--.,‘ ,-•.,,,,
Address. r-P----.22* , - 49-e.:2(7/1 ;• • ' - * ,• Streeta4ddress/State Road/Lot#(s). :-.17 / , ./e).::
City -..:,;84:.4,,,..-'/-1 .- - State. 0.ZIP f ;-7/7-Y -, . ,". /alk_ .../.:2_,..r 7L_ ii.,9,5:74 -- 1.i,„;,. ..:&;:,:,...';',- _ ,--:.:
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• ' - 0 Affected CW /LtEW V14TA'-: 0 ES . 0 PTS - . , Phone#'( ) • ' River Basin . ,e.le 7
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Closest Maj.Wtr. Body , 7, / 4.:- f.---"—: • • , . is,
0 RW: yes /kti'p---?• PNA yes 7 reP
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Fixed Platform(s) /01 ',,,e/./.. / , . . ._•,
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Groin length / 0? \• ' i . R/
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avg distance offshore ---
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' • Shoreline Length ' '.7,/,.,) -1.--- -
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SAV: .' not sure yes 6/ -, . ,•
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• Moratorium: n/a yes to c`' "''7 / i -
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Photos: " yes & /2/147-1-6V‘ 41, -/-•- -) '
Waiver Attached: yes • - /.7 • -•••••,
1.711°) . • ,
!-, A building permit may be required by: ./ A/n/r-77— / /7,ZZ' ' . ,Pet Se note on back regarding River,Basin rules: ,,• . ,;
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(Note Local Planning Jurisdiction) (;---) • .. r) ;--• c - .
• , Notes/Special Conditions -----N eef-/:---- 7i, ./-),7 ,-/-24-Lc-) ,/, ,-i---- ,X-,,;(&„--2,..- y. . ..). ?7/((:),5c7c•-:-.., ..,
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•;, Signatu Please5ead-compliance statement on back of ermit* Signature • .
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Applicatlaree(s) Check# Issuing Date - piration Date .
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NC Division of Coastal Mgt., Habitat Impact Computer Sheet
Applicants44-11 z s Alk ewih
Date:/171 �a 9/
General Permit#: ��jC�'�3
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❑ Fill El Both ❑ Other . �0
/ "� � 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 ❑
252-8 8-2808 :: 1-888-4RCOAST :s www.nccoastalmanagea ent.net revised: 02/03/10