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HomeMy WebLinkAbout73890A_Sawran, Thomas & Christine_20190911CAMA / DREDGE & FILL` GENERAL PERMIT (flew ❑Modification ❑Complete Reissue El Partial Reissue No. 73890 Previous permit # O Date previous permit issued_ v B C D As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ' W Rules attached. Applicant Name L s 5- g v� Fc, /1 Project Location: County g n S Address / 2 8 7 C c, r 4% n ev 0 J R %qd Street Address/ State Road/ Lot #(s) L f / S T, City L y /K��/1 v � / / e. Stat1e ZIP��_� 16 a /d & a q /- ®- , n 4 Q �D r Phone # (515) G $2 - %Y3 E-Mail "t rS Q f'.->C r! @ s r<o (,r(; cry Subdivision �/ 5 -+ L AuthorizedAgentTt� S z 0 i� A , d d r's- City 14 Q 74 {-� �� e / fe/J e� ZIPS `I y 'edwew � 11EW El PTA 74ES ITS Phone # (- ) - River Basin a s Affected AEC(s): ❑ oFr4 El El El El Adj. Wtr. Body �ht r o �Q S�� n nat man unkn ❑ PWS: n ORW: yes / no PNA yes /'no ~' Closest Maj. Wtr. Body�t 16 e� S_ ONE ■■ ■■■=d wMMM I■■■MM■■■M■■■n■ - -. ■�■o■�■■■■�■■■■c■ice■■■■_■■■� ■■■ - ■'�I�iQ�■■■i ■■■■■■■■�■■■®■■■�■■■■ ONE • ■MUREEN ■■■ • i�ilii■■■■■■■■■■■®■■■�■■��■■■■■ • ■■■■■■■■■■■■■■■■■■®■■■■■■■■■■■■■■ ■■■■■■■■■®■■■■a■■■�■■■�■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■�■■■■�■■■��■■■ ■■■■■■■■■■�■■■■■■■■■®■■■� s■■■ ■■■ ME ll�_IIMEMN�Si ■01911M�E 1C�wMwlIIIIIIIliiwM=Uww= �f!l�tl l�i■■■fflis'�iitMEr1�i�lii�■■■v■■�■■N • ■ � � REM ■■ NEMW son's ■®■■v ♦ r r i I • i Agent or pplicant Printed Name Signatur ** Please read compliance statement on back of permit ,� I-I�-,�, IaVS`j. Application Fee(s) Check # i� Permit Officer's Printed Name Sie re .2 /// /Z/ :1 Z/ Issuing Date Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian landowner(s) . The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief, certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: Tar - Pamlico River Basin Buffer Rules ❑ Other: Neuse River Basin Buffer Rules If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215) for more information on how to complywith these buffer rules. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ I-888-4RCOAST 252-946-6481 Fax: 252-247-3330 Fax: 252-948-0478 (Serves: Carteret, Craven, Onslow - North of New River Inlet- and Pamlico Counties) Elizabeth City District 401 S. Griffin St. Ste. 300 Elizabeth City, NC 27909 252-264-3901 Fax: 252-264-3723 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) (Serves: Beaufort, Bertie, Hertford, Hyde, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax: 910-395-3964 (Serves: Brunswick, New Hanover, Onslow - South of New River Inlet - and Pender Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 L p'f /.5 �- N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date 7 11 11 ° NameofProperty Owner Applying for Permit: C; Mailing Address: 1 28Z9 C'ig�eLTon/ 1,3e llcH Z- NWoaNy/CCLe, iV Y /'/ g I certify that I have authorized (agent) �IaSno �i,no��,c to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) L//sec 13uL,/c/-/E,x7n , at (my property located at) 4os-s- 1-7e s;�v,-escLjf ��ds�� %�e-�` , /11C. 1--79vy This certification is valid thru (date) 7 /—/ S b o / ZA • JCu��2. Property Owner Signature G! S-G� os2 l� Date l ��,z lvT S col S -- 1ub7— Complete items 1, 2, and 3. 11 Prinj your name and address on the n so that we can return the card to you. 11 Attach this card to the back of the ma or on the front if space permits. I. Article Addressed to: ; �v ✓; r/. �it a,— 3," 0 IIIIIII�I IIII IIIII I IIIII I II I II IIII I I I I 9590 9402 3499 7275 7245 86 Article Number( _ 701 ❑ Addressee Date of Delivery Ts delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No Received 9 USPS TRAClWG # `r`� First -Class Mail Postage & Fees Paid USPS Permit No. G-90. 9590 9402 3499 7275 7245 86 United States Postal Service • Sender: Please print your name, address, and ZIP+48 in this box, f 2 e CAMA / '�' DREDGE & FILL: GENERAL PERMIT lew .-Modification ❑Complete Reissue ElPartial Reissue No. 73890tL 0 Previous permit # Date previous permit issued_ v B C D As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ! �O Rules attached. Applicant Name:T�n o s FC, /1 Project Location: County Address / 2 I$ Z C r r -1, ti Street Address/ State Road/ Lot #(s) L f - / S T, City State ZIP y a, Phone # G 9Y3 E-Mail +rS (' �c e s ,rr Subdivision SL c, „ S c-„ d Authorized�Agen't 7t� S e ,p }� d c t� City 9,r444 e /4hp c) ZIP � �7 Nam_ Affectedly^ tEW E)PTA PS;?�M Phone # ( )' River Basin Ifok S q 4 •-Vn OEA HHF ❑ IH USA ❑ N/A AEC(s): El❑ ElAdj. Wtr. Body �t M a r- �Q Sou � nat man unkn ❑ PWS: n l ORW: yes / no PNA yes / no Closest Maj. Wtr. Body ri • -d Platform(s) ain Platform(s) iin length -headj;'Riprap length avg distance offshore max distance offshore 0 n, channel cubic yards ramp house/ Boatlift ■■■IN h MEN "MI MMME ■■■raw■■r>�a■�a� Agent or pplicant Printed Name gnatur i SiPle read compliance statement on back of permit � �� 1-I4..,V j Application Fee(s) Check # i �L/bn-+e Permit fficer's Printed Name Si re Issuing Date 'Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian landowner(s) . The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief, certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: Tar - Pamlico River Basin Buffer Rules Other: Neuse River Basin Buffer Rules If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215) for more information on how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ 1-888ARCOAST 252-946-6481 Fax: 252-247-3330 Fax: 252-948-0478 (Serves: Carteret, Craven, Onslow - (Serves: Beaufort, Bertie, Hertford, Hyde, North of New River Inlet- and Pamlico Tyrrell and Washington Counties) Counties) Elizabeth City District 401 S. Griffin St. Ste. 300 Elizabeth City, NC 27909 252-264-3901 Fax: 252-264-3723 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax: 910-395-3964 (Serves: Brunswick, New Hanover, Onslow - South of New River Inlet - and Pender Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/ 17 N.C. DIVISION OF COASTAL MANAGEMENT AGENT AUTHORIZATION FORM Date 7 l / 11 i Name -off Property Owner Applying for Permit: / h oigi'93 1 � ..J � i✓ i'4 lry �� 1. [��C! S j/�t/E f-,' , �� [,�'-e sq �v Mailing Address: 128Z9 (21174L1,3Er9cH )CO,9,0 L YWVOAI// e-I /V Y / Y O 9 & I certify that I have authorized (agent) 7lase".-I '1?1,0,01r'< to act on my behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) �iNr'c 13--�7/�E�,� / / at (my property located at) 4 o � l S'ST / pie S-,` S cL f � cr�i�iS �iic� . /fie This certification is valid thru (date) 7 / / 5S,Z o Property Owner Signature Date 4o7-- / 5-!5-- / s Iu67— 0 Complete items 1, 2, and 3. ■ Print your narpe and address on the r( so that we can return the card to you. ■ Attach this card to the back of the ma or on the front if space permits. I. Article Addressed to: / /(Uv/Cl�ilCt �iew '`OQ� t ",viP�. �/g W Z 3 6 U ,Eff ent ❑ Addresse( ), Date of Deliver) Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No Received Service Type ❑ Prior Mail Express® I I IIIII I III III I II II III I I I I I II II I III I I (3. El ❑ Adult Signature ❑ Registt ered MaiIT'" O Adult Signature Restricted Delivery 0 Registered Mail Restrict( 9590 9402 3499 7275 7245 86 ❑ Certified MadO Delivery ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise !. Article Number (Transfer from service label) ❑ Collect on Delivery Restricted Delivery 0 Signature ConflrmationT "• ;i ❑ Signature Confirmation _ 7019 016 0 0 0 0 0 9926 8334 testricted belivery Restricted Delivery ?9 Form 2911 _ . ii (iv Pni F PRN 7R3n_m_nnn_gnsa flnmoctic Rot irn P—int USPS TRACKING # a ° First -Class Mail Postage & Fees Paid USPS Permit No. G-10. 9590 9402 J499 7275 7245 86 United States Postal Service • Sender: Please print your name, address, and ZIP+4® in this box* lho�� f 2 8 z 9, /1� �3ea�i Po4/ June 26, 2019 Mr. and Mrs. Wayne G. BF 27 Providence View Roa/ / Plymouth, MA 02360 f Dear Mr. and Mrs. BF My wife and I wou' Hertford, NC. I h to send us inforr yours. I'm pleased proper app approvalF �A CAM L that (2 pages ). stamped enve We believe that the prop well. May we also have Received ©CM -EC Bald Eagle Pointe Drive, a%� d you were kind enough d'ae 3 cur bulkhead tie into o �' v yp�eG ki soon as we obtain the .o installation and, if all the O ted in August of this year. �+� r�� y/B a�e�iS'nuyJspd O� it and obtain documentation :Property Owner Statement �O 00 it to us in the enclosed, �0- n our lot and, perhaps, yours as ► % :head into yours? If you have any questions or concerns, p *<-, at your convenience. Our telephone number is 585-682-4743. Our email is trsQro Qom. Our mailing address is 12829 Carlton Beach Road, Lyndonville, NY 14098. Thank you for assistance in this matter. Very truly, __ Thomas R. and Christine A. Sawran CC: Lynn W. Mathis, NC Dept. of Env. Quality ■ Complete itemg 1, 2, and 3. ■ Print your name and address on the reverse so that we can return the card to you. II Attach this card to the back of the mailpiece, or on the front if space permits. Article Addressed to: [iiN k,'CO/47c, FOR/ve n/ewPa�r/i/ews V 19 03C of 11III II IIII IIIII I II I I IIII II ' III I 9590 9402 3499 7275 7245 93 ?. Article Number (Transfer from service label) 7019 0160 0000 9926 A. Signature X I-d Agent _ ❑ Addressef B. I by (Printed arm C. Date of Deliver) ,`-L- ZAr D. IsVelivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No Receivecl 3. Service Type ❑ Priority Mail Express® El Adult Signature ❑ Registered MailTM ❑ Adult Signature RestrictedD§l�� ElRegistered Mail Restricts El Certified Mail® Delivery ❑ Certified Mail Restricted Delivery ❑ Return Receipt for ❑ Collect on Delivery Merchandise ❑ Collect on Delivery Restricted Delivery ❑ Signature Confirmations' — ❑ Signature Confirmation 8 310 Restricted Delivery Restricted Delivery )Q Fnrm Af211 _tudv 9111G DQni 7rzn_r»_nnn_onnc nnmpstin Rptiirn Rprpint USPS TRACKING # Flrst-Class Mail JillPostage & Fees Paid } USP° Permit No. G-10 9590 940fV9E7275 7245 93 United States Postal Service • Sender: Please print your name, address, and ZIP+4® in this box, z v-e q /.3Esgc14 1IC-wAo lisllffilsl1jilllllimillsi,f.fIli, il'1ifl,ilillll'li11111111111 viceIED MAIL° RECEIPT F ail Only formation, visit our website at www.usps.com ". J 0 a 3 9 $3.50 ❑ Return Receipt (hardcop» $ ❑ Return Receipt (electronic) $ ❑ CeRtAed Mall Restricted Delivery $ ❑ Adult Signature Required $ ❑ Adult Signature Restricted Delivery $ -ostage 55 o .... $ . 35 II � ..o, C��f� Postt rk�/ d >l C,,t Here hr 06/27/2019 7 ��ol�<v dill/v2 --- te,Z/P+4e i i� Z3 pf�� ew,da�/�e wsws , V C7 ;ertified matt service prov►aes A receipt (this portion of the Certified Mail label). A unique identifier for your mailpiece. Electronic verification of delivery or attempted delivery. A record of delivery (Including the recipient's signature) that is retained by the Postal Service - for a specified period. rnportant Reminders: You may purchase Certified Mail service with First -Class Mail®, First -Class Package Service®, or Priority Mail® service. Certified Mail service is not available for international mail. Insurance coverage is notavailable for purchase with Certified Mail service. However, the purchase of Certified Mail service does not change the insurance coverage automatically included with certain Priority Mail items. For an additional fee, and with a proper endorsement on the mailpiece, you may request the following services: - Return receipt service, which provides a record of delivery (including the recipient's signature). You can request a hardcopy return receipt or an electronic version. For a hardcopy return receipt, complete PS Form 3811, Domestic Return Receipt; attach PS Form 3811 to your mailpiece; the touowing oenents: for an electronic return receipt, see a retail associate for assistance. To receive a duplicate return receipt for no additional fee, present this USPS®-postmarked Certified Mail receipt to the retail associate. Restricted delivery service, which provides delivery to the addressee specified by name, or to the addressee's authorized agent Adult signature service, which requires the signee to be at least 21 years of age (not available at retail). Adult signature restricted delivery service, which requires the signee to be at least 21 years of age and provides delivery to the addressee specified by name, or to the addressee's authorized agent (not available at retail). To ensure that your Certified Mail receipt is accepted as legal proof of mailing, it should bear a USPS postmark. If you would like a postmark on this Certified Mail receipt, please present your Certified Mail item at a Post Office— for postmarking. If you don't need a postmark on this Certified Mail receipt, detach the barcoded portion of this label, affix rt to the mailpiece, apply appropriate postage, and deposit the mailpiece. IMPORTANT. Save this receipt for your records. __ gonn Received June 26, 2019 DCM-EC Jeffery A. and Kevin S. Krohto 28 Holley Drive Newport News, VA 23601 Gentlemen, We would like to install a vinyl bulkhead on our Lot 155 Bald Eagle Pointe Drive, Hertford, NC. It is our belief that the proposed bulkhead will reduce erosion on our lot and, perhaps, yours as well. CAMA requires that we notify adjacent property owners of our intent and obtain documentation that we have done so. Enclosed please find an Adjacent Riparian Property Owner Statement ( 2 pages ). Would you be so kind as to sign this form and return it to us at your earliest convenience in the enclosed, self-addressed stamped envelope? We plan to have Mr. Joe Riddick do the installation and, if all approvals can be obtained in a timely manner, have it started in August of this year. It is our goal to avoid further erosion during the coming hurricane season. Mr. Riddick has installed many bulkheads including one on Lot 156 and, has an excellent reputation. If you have any questions or concerns, please contact us at your convenience. Our telephone number is 585-682-4743. Our email is trsQrochester.rr.com. Our mailing address is 12829 Carlton Beach Road, Lyndonville, NY 14098. Thank you for assistance in this matter. Very truly, Thomas R. and Christine A. Sawran— CC. Lynn W. Mathis, NC Dept. of Env. Quality ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to /h�a�i.9s /l,€'',fTA,c %S.4 c..trr�.v I (Name of Property Applicant) property located at _2/9 13,94a C4 « 7-E7 f/ ter, -ono A `7g yy (Applicant's Address, Lot, Block, Road, etc.) on /,�c�E,�����F S'v�.,�n in %ECc���.��- � fY , N.C. (Adjacent Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above locationV I have no objection to this proposal. I have objections to this proposal. You can mail any objections to 401 S. Griffin St., Suite 300 Elizabeth City, NC 27909 If you have any questions you can call: 252-264-3901 DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) �c �o�r� i//� fo /' enla ✓e cz���ox��/ k,fe� l/2 8 /� eJ/ o� v'ip rn/' � t�s/%L.�� � fkr+, ,oAce -11*'1110r4,.o .&I -ee., X.14' ea.rJ a4q 1, c Received ®CM -EC (/P/�rope//rt O/y`JA[ner Infor 6t)ion)j (Adjacent Property Ow,_eIr` Info mation) 1 G.XI✓i1tK.�� V N:W A�/�y1 �^'W <iYi L. z, _6 Stature /� Si ature * �/ L- /ttGM195 /C. �l9Gc/��9N �'y�/sr�Nf .9.5A�✓ J EFFE�2Y /T /�i?GI4JO l�f�%,t, S'/��4'oriTv Print or Type Name Print or Type Named 2v tZgC�2,ec7WY 4V,-CH 2deio e-6 f o,-LEY ,ciyuE Mailing Address Mailing Address / ,V 0 9 0 /,/EtuP n r /VE w s VA City/State/Zip // City/State/Zip %�9S) q-8Z-S/7y3 ��J"S�rdc s?er r�^camas 7 30(0 Telephone Number/email address Telephone Number/ e ail address ��/a����/i Date D to (Revised Feb 2017) *Form is valid for one calendar year after signature* Received DC -EC ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to ���rgs /e,f� .olza, 1-2 's (Name of Property Applicant) property located at Z/8 E3ACD EAC�c- /`'a��v O�ive /-EICTI-C ;o IV e- 79 v y (Applicant's Address, Lot, Block, Road, etc.) On In /-19E/�p1- Uy7T;/ N.C. (Adjacent Waterbody) (City/Town and/or County) The applicant has described to me, as shown below, the development proposed at the above location. I have no objection to this proposal. I have objections to this proposal. You can mail any objections to 401 S. Griffin St., Suite 300 Elizabeth City, NC 27909 If you have any questions you can call: 252-264-3901 DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) 7-he- oalcwv </ /L8 feel o//^p its �� �7en /0/cr r'ijo; •quo 6c7wPtn /�u�i��itad �u A e Received DMEC ' (Property Owner Information) (Adjacent Property Owner Information) Signature /J Si �re wc- Print or Type Name /� Print or pe Name /Z 8 e % CARG7-V �l A3;S-VfN /CORD Z 7 /"2oL'i V/ E4/ �Oi9 ✓� Mailing Address Mailing Address /V y / Y o 9 F?G e-, l o Lr zye _ /tl/9 (32 3 C f1 City/State/ZipC$"HSCitStatelZip )G82-Y7y3 /"sCna,1V S1ck-.e:rcti�-7L/-7/_3` q A66AS PW�-kChg 41L Telephone Number/email address Telephone Number/email address C./Zr �2a/!i l Date a (Revised Feb 2017) *Form is valid for one calendar year after signature* Received DCM_EC 8i82019, 11: 56: 29 A M perquimans_nc_misc perquimans_nc easement perq/uimans_nc_lot I/ - perquimans_nc dims Perquimans G IS 1:1,128 0 0.01 0.01 0.03 mi perquimans_nc acres -f -a �' 0 0.01 0.02 G04 km E srl, HERE. Gannln, (c) OpenStree"p contributors, and he GIS user ® Imagery2016 community (J Perqulmans G I S For fax purposes only. Not a legal document or survey. Perqulmans nor Slaty of NC assume any liability resulting from use of this map. July 8, 2019 Received J;�_j�� , Lynn W. Mathis, Environment Specialist II DCM'EC NC Dept. of Environmental Quality, Div. of Coastal Mgt. 401 S. Griffin Street, Suite 300 Elizabeth City, NC 27909 Re: Installation of Vinyl Bulkhead. Lots 155 and 162 Bald Eagle Pointe Drive, Hertford, NC 27944 Dear Ms. Mathis Enclosed please find the required, signed adjacent property forms for owners of lot 154, Jeffery and Kevin Krohto, and lot 156, Wayne Bogosian on Bald Eagle Pointe Drive, Hertford NC 27944 in The Shores at Landsend sub -division. As I was not sure of what other documents you might need, I've also enclosed copies of our original letter to the adjacent property owners, original certified mail receipts and the Post Office signature cards. Charles Purser is our General Contractor. He has indicated that he will sub -contract the bulkhead work to Mr. Joseph Riddick. Mr. Riddick thought that the work may begin as soon as August pending all Government approvals and other work for which he is currently under contract. Mr. Riddick will also perform the same work on our other property, lot 162. Thank you for sending me information regarding the adjacent property owners for that lot. I will send them adjacent property forms to them this week and will forward them to you should they elect to sign and return them. If you have any questions or concerns, please contact me at your convenience. My contact information is: Telephone number - 585-682-4743. email - trs@rochester.rr.com. Mailing address - 12829 Carlton Beach Road, Lyndonville, NY 14098. Thank you for assistance in this matter. Very truly, Thomas R. Sawran Received DCM-EC NC Division of Coastal Mgt. Habitat Impact Computer Sheet Applicant: b .tn 3 Y— Lr ri S �i,w u.. Permit #: 7 3 ' l Date: q 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)/ Sko(�V ra� Dredge ❑ Fill $- Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other &�— Z,S (p --�. 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 ❑ 252-808-2808 1-888-4RCOAST :: www.nccoastalmanagement_net revised- 02!03..10