74166_Dan O. Campbell_20190925

. ' �' CAMA/ ❑,DREDGE & FILL .t��r�C t No. 74166 B C D
ENERAL PERMIT ` D 100 Previous permit# ssA
A
>( i!New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit ued /U/A
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 (S?0, Z P90
_ ) ❑Rules attached.
Applicant Name DAt 0. CAM? GE et_ Project Location: County }71I MC/C 0
i Address G t q S(o77 A v Diu A C Street Address/State Road/Lot#(s) I/O G FOg iK
City (1C rEA)SSOR0 State,NC.- ZIP d� '(4 3 FetwT 1ED
F Phone# (33 O 706-0 I(3 E-Mail Subdivision ro.,le P01/47-
Authorized Agent R j C IC y .S'7K0 u s f City O K I W fA L ZIP 2,8+5 7
Affected ❑CW )EW /v PTA ❑ES ❑PTS Phone# ( ) River Basin E(.)5( '
AEC(s): 0� ❑HHF ❑IN ❑UBA ❑N/A Adj.Wtr. Body -i-U'iL CJ11 i t (nat an /unkn)
❑ PWS:
Closest Maj.Wtr. Body N(L 5L le I(lc 1
ORW: yes / e0-1 PNA yes 0
C Q t ) 2 A 3 (r/4
Type of Project/Activity (-( O(Zl�n/C C. L40 I G F/� �U ix Sir P/�2 l (s/ l f E�
p
r I k$. (Scale: / "• L/O )
iE Pier(dock)length I g0erce(
I" Fixed Platform(s) — ,1
Floating Platfo s) ��Y / r — -I , ' 1. 1,, 11E J�g� H„
„ uuik Groin length JiiiiIIilluI
�� .tee
Bulkhead/Riprap length �' ,• ■■mi■.■■■■m�
avg distance offshore "' ■��lia ■�■■■ �illS• �� 11171111
max distance offshore r , �,� ,
Basin,channel ■ ■.■M■■ .r �■■■.11®■11■��OMMIII~
• •.U.u.�I V d 1 •�U .UR �� wYJ�•U:oa1Tsl (k/ 1t1Ioaoustift -`
Other BeachBulldozing L
; g .t,tL,
Shoreline Le SO 111111 . : ■■ IlliloiHol
SAV: of sure yes no IlIIIUIIItL!Iflh1IaiI
!_.._01110111
�
Moratorium: n/a yes 4:111► ___I 1•11111111111�111211111.11111111111 ����■��:: 11��
Photos: yes ; _ UUUU•��
Waiver Attached: yes
A building permit may be required by: PAil I I(C) CO()/Jr/ . I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction),
Notes/Special Conditions )I C 0?►l. 2 f O 0
(/ -1
goyc A :)P2(a(4t. ..� .1 r- lr- V fed I-IAR-r
Agent or Applicant Printed Name � Permit Officer's P'nted Name
& (
' Signature **Please read compliance statement on back of permit** Signature
E Xr P l 7 _,5(Fr 2Ci'1 • Zo S r pi 70z 6
I Application Fee(s) Check# Issuing Date Expiration Date
'#-'y � .... a s _ . ,. '

Applicant: DAij AM f B K<<-
Date: 27
s1u z,I c(
General Permit#: L'It G r 13
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.
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)
epr:Al IPA fib- Dredge❑ Fill❑ Both 30 r r PT j 2
❑ Other P� IIV
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill 0 Both ❑ Other ❑
Dredge❑ Fill❑ Both 0 Other
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both 0 Other ❑
Dredge❑ Fill 0 Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill 0 Both ❑ Other ❑
/Gf� if
S' It a
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