74121_Urban Boutin_20190826

•XCAMA/ REDGE & FUL IDI4P NO. 74121 A B C ��
PERMIT �� Previous permit# 4
ENE L . .
�C ! ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued )0/4
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 I 5A NCAC (O-7 I•1. I)0 Co
❑Rules attached.
Applicant Name IA R QAn1 fO 1 f 1/J Project Location: County (,J k 5}I fr./G72)i✓ C ou uTY i
Address 2 EMU?At 0 / Nl Street Address/State Road/Lot#(s) 29Z F_"M1bALU
City K0j2CK State/VC ZIP"177TO lA) Ori- A)C 3 Z
Phone#( ) E-Mail Subdivision / /`1•{i'A l 0 LTC •
Authorized Agent I VA/I .$AwYCfZ 91y- y ?(0 City (LOef_/L ZIP ;?270
Affected ❑cw lyiw 1 PTA XI ES tOTS Phone# ( ) River Basin PAs&u b!A pi IL
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA III N/A Adj.Wtr. Body k i1I Aiz L L 4 au Ni) arl an /unkn)
❑ Pws: r4/i' U_ Soo Ahl
ORW: yes / no, PNA yes / no Closest Maj.Wtr. Body At or j
Type of Project/Activity A IA%1 1nR I Z(0 'CYO IAA C K U FAP
4
(Scale:I .-7.2,0 )
Pier(dock)length -► I
Fixed Platform(s) ( I ` s
_1__ — - —, I - , -- —
Floating Platform(s) �rI
ACC Fig 11b
Finger pier(s) ��
Groin length —
'.ber
f :ulkhead/ 'iprap length I
/ I
avg distance offshore 2 / I
max distance offshore ,2 I i
l
MBasin,channel - i ( f
cubic yards I
Boat ramp i
� J t
Boathouse/Boatlift ;042
i�` y�' ./ 11 1 S r
Beach Bulldozing f +
I —
Other -----1------- ! V . •
of 1 f;'/� /i,
Shoreline Len
SAV: not sur yes no �. — — —
t 0V
Moratorium: n/a yes no hO I
- T
Photos: yes Waiver Attached: C� es no i I I I
A building permit may be required by: �,IlI S N/+J LTh� Coda/J T`/
I I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions ,%r 1 67 0 1160 C ohs/7 /7U,J`i.9 Cock-r N rLA r' I,/A iX/C t,//t129
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. 1vf , r' SKW 41 KL Viii IIA
Agen or Applicant Printed Nam Permit Officer' Print Name
Signature **Please read comp nce statement on back of permit** Signa ure
4(I6o. 00 IS-CB 26 Aw, L0lq 2‘ pc ( eel
Application Fee(s) Check# Issuing Date Expiration Date

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Ifc.t-ehy authorize Samvr r�, �,tcir rrtra 1 r rr t � Area
(Name kit person or rota treaded ° eede for the
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I o act a myagent for the purpose�;e of r ht r rr r } � pit, i11 ►t is entails:
anagement Act and/or Dredge and Fill Act I r. , ert '- '
proposed development at the above indicate( l
_ Install a New V in 1 B .lkhe d
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begin
sought)
(Describe proposed development for which 11 ex
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• above.
and
This agencyis limited to thespecific activities desert
'ed
on: 12/31/19 -----'"
(Date on which authorization expires)
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(Date)
(Sl;y ature)
fide, if officer of carp. owner ate
(Printed name of owner)

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Applicant: (A )7 /" nd u T1.�
Date: :26 ALAC, ZOt '�
General Permit#: 7 Li 12 1—i5
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.
Hawi a 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)
,S 14o12E Li JE Dredge❑ Fill 0 Both 0 Other ]�' I G c, �2o r r
• I!l Gm ( Qot„Dredge El Fill El Both 0 OtherI124 /66t r' I 7 F
Sp
A(Lou Barr_ Dredge❑ Fill❑ Both 0 Other 18 Q F r 18 d(_ r 2'
Dredge❑ Fill 0 Both ❑ Other 0
Dredge❑ Fill 0 Both ❑ Other ❑
Dredge 0 Fill 0 Both ❑ Other 0
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other 0
Dredge 0 Fill❑ Both ❑ Other ❑
Dredge 0 Fill 0 Both ❑ Other ❑
Dredge❑ Fill 0 Both 0 Other 0
Dredge 0 Fill❑ Both ❑ Other 0
Dredge❑ Fill 0 Both ❑ Other 0
Dredge 0 Fill❑ Both 0 Other ❑