67205D - Coley

(CAMA / ❑ DREDGE & FILL �/ / 205 A B
ENERAL P RMI / tf 1 Previous permit# S
Newcodification Complete Reissue ❑Partial Reissue Date previous permit issuedlog
ized byte State of North Car ina, Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC (; a
R I
t Name�A-
State I
-Mail
ed Agent
❑ CW AEW *A
❑ OEA ❑ HHF ❑ IH
❑ PWS:
yes / *6 PNA A�� no
Project/ Activity
:k)length
itform(s)
ngth
nber
i/ Riprap length
distance offshc
x distance offsh
cannel
sic yards f
Ise/ ift I N
ulldozing
/
e Length - (�
not sure yes no
Ro
ium: n/a yes (no
yes no
kttached: yes no
ng permit may be required by:
Local Planning jurisdiction)
❑ ES ❑ PTS
❑ UIRA ❑ N/A
❑ uesa
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City-Gl - ZIP__
Phone fif-(-- ) River Basin W
Adj. Wtr. Body at r
Closest Maj. Wtr. BodyAl
- CI r,-1" I /,
(Scale: I
❑ See note on back regarding River Basin ri

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: AAp�, 4- Co Permit #:
Date: 1,4c
y
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. FINAL Sq. Ft.
(Applied for. (Anticipated final
Disturbance total disturbance.
includes any Excludes any
anticipated restoration
restoration or and/or temp
temp impacts) impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts
I FINAL feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
am nt
DDredge
❑ 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 El
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 0 Other ❑
Dredge ❑ Fill ❑ Both 171 Other ❑

CAMA / El DREDGE & FILL
II ENERAL PERMIT Previous permit # A B
New ElModification ElComplete Reissue El Partial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources
:)astal Resources Commission in an area of environmental concern pursuant to I SA NCAC
EMules attached.
Name Project Location: County '%I.A4 '
State ZIP
E-Mail
cl Agent
El CW
DEW El PTA DES 0 PTS
0 OEA
El HHF El IH 0 URA El N/A
El PWS:
es / no.
PNA yes' / no
Project/ Activity
Street Address/ State Road/ Lot #(s)
Subdivision
City zip
Phone # River Basin
Adj. Wtr. Body WvV
64 /y
Closest Mal. Wtr. Body WVV —
Al VV
(scale: 4
J
6er
Riprap length_:
Mae
OEM
NUUMENEEINN
EMSEE
EMEMOVENEEK4011r,
�-istance offshore
d1swce offshore-'
MMMSEEMERHEN
EM
WEISEW
ENEENE
MIN
mom■ENEENIMENNEEN■E
NOMENNEENEENEENNES
LEE
NEE
g permit may be required by:
ocal Planning jurisdiction)
D See note on back regarding River Basin rt