TOWER GP68260A, 50282 Kings Point Dr, Frisco-09202017 0001

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GENERAL PERMIT
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Dace prencua permit issued
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NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Apofcant jylGV Jh<. a. /C4rcy �/' Formal : C,82w A
Dale:
Downba below the HABITAT tllsNkaroeB lwlM10 egYkatlm. All values enable match He name. and units of measurement
found In your Habitat coda sheet.
Habitat Name
DISTURB TYPE
Lbob oOne
TOTAL Sq. FL
tweenlw.
mcladesanyel
Idaved
hopeful
FINAL Sq. Ft.
(MticipatM real
6mmsnce
E=1aa*any
eatwatim
TOTAL Feet
(weed few
Noumea,
Idal0I
ay mticpaed
FINAL Feet
IAammM II
dawtanw
EmIWwany
empmlacln6
Open teJcr
battle Rap ban paxNo
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Sl4f{0
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decade FIR mmp ana❑
urrine0 FIN deal peer❑
uraane 0 FIN min 0 Lear ❑
evade Re mm❑ der❑
Dreeee0 FIN mmn after
create 0 10 mm 0 Later ❑
latent0 Fe10 awn0 Later❑
Orecne 0 Fa 0 aem n otter ❑
omen¢ 0 Fa p Damn 0 Other ❑
Dreege p 10 awn 0 Other ❑
Device 0 FlI 0 mtt 0 star ❑
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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date t-i8,-I-7
Name of Property Owner Applying for Permit:
MIIIIng AddrlN:
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Icertify that I have authorDeJ(agent) may/ eWsye xta2 to act on my
behalf, for the purpose of applying for and obtaining all LAMA Permits neceanry to
install or constract(activity) G!/Lc-/r.✓dy 4^j Fi OCAi
at (my property located at) $0.n'rl2 N-F—
f��tt �'�� NIr- z7436
This cerHOotlon is valid then (date)
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Property Owner Signature Date

I hpMytertly Nall near property edJaosMa lNxRl. �l!.L <lAnt ��u.n` :;r' y
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The Tpofrint hos dl»alb d to m0. ss sham bo!am. the dovalopmeni proposed at do above
xatlon./
_'•Y�_ I has no obJectlon to We proposal.
I have obfecaons to V-11> Y. r!. .
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