75378_Said & Judith Darvari_20200417

' z �� � t 44
,cAMA/ L"DREDGE & FILL ['7 No. 75378
AGE C D
GENERAL PERMIT Previous permit# *I17.t
New 'CModification [ Complete Reissue L.7Partial Reissue Date previous permit issued µ 1 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 ISA NCAC 01 h) • I z-c'C''' .
!.Rules attached.
Applicant Name `5A+D ci to 0 n-N ')AY/a'2 L. Project Location: County lac 'trt7Z r 6i .
Address )(o R" L.kr r-1 1 P Po0`t I Street Address/State Road/Lot#(s) al n)C. 14 t: g-.,
City /75A n—I —_State t-tc ZIP-2-110% E'_ )6 L 1 rt ,.}2 fa,.4—r.
Phone#Wig,)_.04/' ^0 7 E-Mail — Subdivision CA-r-ri t P P 0in( r
Authorized Agent--r: 'S .M44t4-C .--.__. 2) Oct�rtY_"tan.-..tom_ ZIP
Affected 7 cW ❑EW $PTA 7ES OPTS Phone# ( ) . River Basin'TAg- P fy./rcJ_
rrOEA OH-IF ❑IH JUBA ❑N/A
AEC(s): Adj.Wtr. Body!.,}'aantj:N PPr1 _._ , nat man /unkn)
ORW: y� /�PWS: _ ell-
r
� PNA no Closest Maj.Wtr.Body_ UCC7_, iJ
pb
Type of Project/Activity to t4c,wt,,t , r 1 6' v\+a 1 c_OWcrzt.a ?LAI�-,cart
(Scale: ) ='3d1 )
Pier(dock)length` ........ .r.. .._._ _. ........ _._— , . •_ . ...._-r
Fixed Platform(s) i.�'y t r`at I I. I & 13(rntI, ccatt.'. I . ' . : .j
Floating Platform(s) _ _ I i- I '
C..>sfxinzs+Ec' 1 { , .::( t 'Z.-�m�auGr '%tglytWit ;
Finger ier s _ 1 ....... tiL`r! _ a ! „ I (Zri`/4 ,b"r'tt` pe . J 1
Groin length i _._ Grpt,cnC_£n t ltLi e tr..-� - .._ - . ' — J,�
number I, ..'. i .9 ♦ > .i.:... i - ni 1
Bulkhead/Ripiap length ( • I \ -r D S••t Y' j��- '
avg distance offshore - 1 I _�f,_.� - _ 1
max distance°fisher I _ _a
y '
Basin,channel t ewttrt 1 :at X'2 S i t�.1S»4h F7t44r_cic `
_______ I - - r-.r iTirrt.3 eat r 5-r. i I fo,a:3 5* t
cubic yards
Boas ramP-.... _ 1, . i ''tt'RIUtt-s LSii.dol PttOt..__ _- 1....,_a....._I
3t'.`$f3 ' I F ,
i
Boathouse)Baulk__ _1' i '-
I
, 1 t Beach Bulldozing _ { ' I '
Other - -. ---
I
Shoreline Length )0 tJ f t i ! It t { ' I
SAY: �.o t. yes no i - i r: . CI-- :.
1- 1�3t.t trtSt_. C} . _ I rye-let it
Moratorium: nta yes no j I .9Z011
Photos: yes no I 1 ClaIV*4 'ro'4'� • •
Si I r a i
, I I
;
Waiver Attached: yes no :.._. _ _ _�— .___.,.
A building permit may'te required by:'-Tcw:.1 ©_. Thorn-)- See note on back regarding River Basin rules. -
(Note Local Planning Jurisdiction)
Notes/Special Conditions "Ts)to 0 G>'f= Vf,R-ST) `2 Lai-ILL r le.:) C°Pe t/Fc Y-c c Atrtc r.r-}-20 .TFI-t
7,Ji F tf", 5 TIC'o0w'-I t_.o 4-4,-crtD I0 LAD et S.-• P rut.ut 51-- BE', 7)-._E+"+eUL"WJ -r-i (o4PL'-,
Wt-t-r{ T0-? 4;0La-LE Et - if 72-b2iD-n Rt%•_tttir--I\it, ?t70:-itLr LOU.'- 1P-LK6t44- ir) €Qp OP
�o% ed >2E , �,� „e
A nt i A pl nt� nted N Permit (titers Printed Name
ignature *`Please read compliance statement on back of permits* Signature
uv
_GYA tAkit ,.._ L1><`a rya q-r_ I"7 As>ait- 2.,a-20 r"b ALt_h ot')-r 20
Application Fee(s) Check# Issuing Date Expiration Date

0 'CAMA/ DREDGE & FILL No. 75378 A ® C ID
GENERAL PERMIT Previous permit# N 1 A.
>� ' New 1Modification ❑Complete Reissue .-1Partial Reissue Date previous permit issued 0 1 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 I 5A NCAC f�-)h1 • I z- .
r.,Rules attached.
Applicant Name 5A'' I ,w Orr 4 D AtlA'i -% Project Location: County 8t bC r (o .
Address 1(o Q- C.-An-0 1 P Fe,0-1'r Street Address/State Road/Lot#(s) on- IN C rl wM-f 9-
City 7A1 7-1 State 1-1C_ ZIP 2`7 Is'o% e l(o 4- G< 3r r-rJ I lP f0.'-x-r-
Phone # (y19 )70*^b-7-7S E-Mail Subdivision C-A774 I P POir.) r
Authorized Agent T 7`s Maq),.4,a City l3Pr,—4 ZIP -l )g c)<6
Affected ❑CW ❑EW X PTA ❑ES ❑PTS Phone# ( r►'_ _) River Basir ,gl.- kw./'c)
AEC s : ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Bod a man /unkn)
ORW: yes / PNA �� no )tJVA-� Closest Maj.Wtr. Bodyv'!c� "�ZttJC�-
Type of Project/Activity c; ..r.,-,z , _ 1 b‘ k 1 U. c-c e rT ;> A1 -c,;2• \
p I
(Scale: 1 = 3J )
Pier(dock)length
Fixed Platform(s) 11:;k l(0,/ 8 I .-. ! 1
f.G .12KG.- - j 1 i
Floating Platform(s) i {_ _ _ _r—'' *J�yv�ci� il,y��t1
Finger pier(s) I I - 14'' f l b I C �(Z#r4� ST e.IDI�w i) !
Groin length i ! oo eo 1 L.q _-_,,__—� ---_ h611 I
number i sr /�
Bulkhead/Riprap length ! \
/ ---I o l 1�I
• 4�iV 1
avg distance offshore /1 1 \ "I 1
max distance offshor • '
Basin,channel i -. 3 L 7,"Z,$' r
Ci-isermuj � �I )Ni, c ex..,
-r-- -r.a- e'2 i Z' ). `. / _!'►/ I x 3 ri
cubic yards - L ,ram
if J
Boat ramp i - -_'re ',Ili P/at..]
Boathouse/Boatlift —
._.
Beach Bulldozing I — — I
Other I
G G ty-Ttf0,,i_apitt*rMs/+0 __i__________________.
Shoreline Length T
a
SAV: not s yes no _ „ . . _
—_ — r ._
_----
', I� L C c-C., C _ I I A -r-K.z---3c,
Moratorium: n/a yes no j 4 _ %)*✓
Photos: yes _ j i :
Waiver Attached: yos no '
A building permit mayiSe required by: --Tx :J D 1->"\i-s4 . See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions --row 0 O F RPtTh ---0,-1-st-Ic7 L o 'pt-t i -- ie A15 1 7\4 t'f-e0 " z
fF y''' Sm 6'Ouw.1 L,L.--4e1'e-o ►tl !ate St..ta I,.Li.Sr 8c ' r►0Vgp ^>~~, n0t_‘1
w c-t-r-I -rW-1 B S GI.-A t-F rtx> t TZ"ts�,Re ✓r I+1RL P2n_�tzc- W iu- 1 t Lt )7N1 DO T} ()'
?L -r OiL'. . -
Agent or Applicant Printed Name Permi fficer's Printed
r--------(....
Signature **Please read compliance statement on back of permit** Signature
v✓
pat C.VI L 'I-2-C7 _U� 1 30 r L- 1 Apia.r t- 2,D 2-o 1'1 Asii 1,t,t.5 r '12.'3-0
Application Fee(s) Check# 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 I)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:
x,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 (252-946-648 I) or the
Wilmington Regional Office(9 I 0-796-7215)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/ I-888-4RCOAST 252-946-648 I
Fax: [phone] Fax: [phone]
(Serves:Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 9I0-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare, Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

Authorized Agent Consent Apeerneng
(0. )
5 I.
esti oi/'-/ ,itrbaly authorize Tobin Jay Tet-terton
(Property Owner(s))
TJ's Marine Construction, LLC to act oilly behalf obtaining CAA permits fezz.
tiie location listed below.
PROPERTY ADDRESS:
Ll ot .11)
\s. "
g7)
PROPPRTv OWNER'S MAILING ADDRESS:
r I
Phone No. • - • d - ) 7 Z5
PROPERTY OWNER'S
AUTHORIZED AGENT SIGNA.TURE:
T BIN TETTERTON
DAT —
W/Authorized Agent Consent AD-C .

L(
TOWN OF BATH DATE t l 3
BATH, NORTH CAROLINA
BOOK NO. PERMIT FEE PERMIT No.
APPLICATION FOR: BUILDING PERMIT( ) ZONING COMPLIANCE CERTIFICATE( )
Name & License No. Address: , Phone No.:
OWNER -S4 Ackrt Starts-/1/60d (th4 /L1G ';r 9/f 70`/677k
CONTRACTOR %ems a ar,r�P 0p UMt ri
oo a 1) 'I 3 can d Ifs-9X1i677
DESIGNER
SURVEYOR
ELECTRICAL
PLUMBING
TYPE OF IMPROVEMENT
NEW (✓) ADDITION ( ) ALTERATION: INSIDE ( ) REPAIR: INSIDE ( ) MOVE ( )
OUTSIDE( ) OUTSIDE ( ) LOCATE ( )
Lot No. Block No. Building located at
between and /Streets. Building to be used as
. Type Construction/'7/l� ,/4 /1,1- Y-62c6O
Number of off street parking spaces . Contains rooms and bath(s).
Total square feet of building . Electric Service . Type of heat
. No. of plumbing fixtures . Foundation block caps
4"( ) 8"( ). Corner bracing: Plywood ( )other . Insulation: Floor -
Walls , Ceiling . Windows: Storm ( )Thermal( ). How many exterior doors.
. Water Heater: Gas ( )Electric( )Other
Roof Ventilation: Gable ( ) Eaves( ) Louvers( ) Other . Ventilation
crawl space, number of feet apart . Height of crawlspace under house: 18"( )24"( )
Other . Zone .Water and Sewer Tap: Paid ( ) N/A( )Size water tap
Size sewer tap:
Total Estimated Cost Flood elevation

I
BUILD G INSPECTION DEPARTMENT COMMENTS:
p etc S ucen,J o-P Q ,/EX / 7/G rirb a%ir
I,JG/�ay��n� a lie- lJ��re� �r`�S,le_. ex=r7%� ,
GENERAL COMMENTS: j
14Mg (AZEro au Cw-rH cfAE OF FJ,ucn,ut -pia_
5 T$AG1G c Ho Os 34' V2a4 6,4zCE0 To St:.tern Payipci2 y
[..-0.4 . T-tTxL St> Faor ..w APP/2-i1, G'ee, Tay /GA on° '
SITE ¶jisiTt ZD ' MoLT eLAJ S j- 4Gc t1Jtt.t, is Lim GNAJJ61:0,
i
CITY LICENSE NUMBER: 4on
. Contractor/A -. :n Plumber/Heating
Application approved by: th
�� ` -' - ^ZD
The owner of this building and t e undersigned agree to conform to all applicable laws of the Town of •
Bath North Carolina.
70
Signature of Applicant G
Effective 8/10/04,there is a $50.00 filing fee for all permits, including zoning compliance application. `
Any construction that requires installation of water or wastewater services may:
A) Be installed by owners, contactors or li
B) Be installed by Town of Bath Utilities Department
All components must be compatible with existing water/wastewater materials, including Myers pumps.
Bath Utilities Department must inspect all construction prior to services becoming.operational. Inspection F
fee is $100.00. '
r
t
q
a
s
I I
I

k
a%"Ftri
•.- .i,..afir ,2 i? x
I
`it - '' �.,� !' 'f' 'Ym1/� CY
err
irk a 0.
8
'�@ i Xy g
Po�1 'L Ei'rwJ { tc} F.{v4 / a>�n2 v
3 Z
a ,may +� �i
rfaan nil .f °•dip pr°,z x q 3 4r ,��� rs+
Prk' P z tt
1� Y >M. ems .
tljte
,r M1 jvy,Q t t
v } ,� G
Beaufort County, P/ ' GPIN:665319- 504 PROP DESC;ILOT 910 YF(ASE I TOWNSHIP:07
OPINLONG:6653-19-6504 CATNIP POINT MBI.:65530U145
NAA11i1:DAVARI-NE.IAD SA HD LAND�VAL 22572U PM.I:07001118
Disrlxmor: EiLDO_VAL:219317 DATE:7152018
N<nnNn Cwnry nn0re mapnccexx ix pmaaedi apamiv urvw,,m ie,.n NAME2:DAVARI-NEJAI).RIDITII TOT_VAL:445037 DE PG:l9fi4/00920
a vmbm wd wimnnr wm,>,nincxprruw or implies.ewtempd,lWw.l rc, '1'AXABI.F..VA:445U37 STAMP5:934.00
rbix webeik ix 1'prinPom,ntivwl panpe monly eng isrex intended rprwuti[uba
legs rceusd vvrxbvvld ix bvwbrivrted lvah:edviaprsmiaxofindnnry ADDRI 1fi4 CATNIP YOLN'T DEFR_VAL:0 SALE PRICE:467000,00
pmfrsivnxb:nw Cmnryof0evuhrtatd Ae tYnlriu Pmviderai¢laimyl art:BATH
PREV_ASSES:512GZ0 REIDI:35013
rcepomibigryav4 krfoiaC unny fur contenrpubl¢Fb vvdtrawbsiu.tbu
,ver.grce Marxewlvrc[avmy anaam nxpgrrx mast bat tnrintm xem nn S'IA"IE:NC ACRES:U,7N
xwva,dams,uanngn nrJ„asmrnm is�r vwpfJn,ravf GxmlYdm.. ADDR2;169 CATNIP YOIN'T PROP ADDR:164 CATNIP POINT
edr W,utnrtreagampi,xcp,n BD
b 90m APr/10202 ZR':27808
120C R I 5 aIc I1

•
, •
1 .rap* - o: �' 1�¢
3 y,1` 1 '
r K
\ -:.
•
t S� r k'k..— ti mar L✓� �1; . s t .
„ILI
•
I
•
i .
} y .
Y ,. ..:
w'
Beaufort County, NC l- `• u653-19-6504 I'ROI' DESC:I LOT6IO PHASE I TOWNSIRF':07
GPINLONG:6653-19-6504 CATNIP POINT MBI,:665300145
NAMEI:DAVARI-NEJAD SAIID LAND VAL:225720 PIN_I:07001118
Disclamer: BLDG VAL:219317 DATE:7/5/2018
Beaufort County online map access is provided a.4n public service.asi!,as NAME.2:DAVARI-NEJADJUDITU TOT_VAL:445037 D13_PG:1964/00920
available:nd Isithout na:rmnies.expressed or implied.Content Iwhuslted on TAXABLE VA:445037 STAMPS:934.00
this ssebsi a is for mfor ouond purposes ml.)and n not intended to constitute a —lessl record nor should Itbe sulsmm ;w ted for the or services of iruiusus ADDR1 :164 CATNIP POINT DEER VAL:0 SALE—
PRICE:467000.00
professionals The Counts of Beaufort and the Webste provider disclaim all
respomlbitip and legal liability for the comsat publshcd on this Hebsite.The 1 CITY:BATH PREV ASSES:512620 REIDI:35013
user agrees that Beaufort County and as Assrsns shall be held harmless front all STATE:NC ACRES:0.78
actions.claims,damages or judgments nrsstng out of the use of County data s
beaufortnc-agdmzps con ADDR2:164 CATNIP POINT PROP ADDR:164 CATNIP POINT
ZIP:27808 RD
le 20 m Aptl10/2020 ,
loft I Scale 1:903
I._______ __.. .._" _. " __ __..... .._ .._ .... .._..__ _ _.._____ -. �_...__.._.....__. ..... ,_

ER.M€iaEWaa'
Y cettfir that I own prop=n Cl adjacent to '` r ,T '— 4 /J
1 hereby
gape sated at ! art-7 eris
of tat j- '
on }f Pe / (Aoiciress, Lot,E c° fie_ et ) //
{tJaterkandyr 1° l /"Y ;,
latiffiewrs and/orCounty)
i.c,
.. - The applicant has described to me, as shown below, the development ent proposed at the above
local'on.
mr w I have• .objection,to this.proposal
Osvx,-
rn-zo I have objections to this Proposal.
D sCRO€'¢'§ollf s®RiD/oR Pe®l o'E®DEVELOPMENT
.. ariddi9ltl£Esf yi"Up©Si7! development
r
g :mj tiili in cie. C Ation below or attach sits
aaZae,- a��a��l-P4Nllrfg).
I
2i' j / LX /g / 2 6
•
' �-y I understand that a pier, dock, mooring
__ must be set back a pier, d minimum distance pilings,
bomvamp, breakwater, boathouse,
;"g me. Of you wish to waive the setback, rse= lir, or groin
( area of riparian access low.) waived by
__ you avacas• a the appropriate stank below.)
14124. 1 I do wish to waive the 15'setback requirement
I do not wish to waive the 15'setback requirement
Gop-rf�seer? ;�,r �.—� -_
rrattoraj —_
C.— � ^ Gj�<^,e� �4�?NeeiJ .. u.?..i a�i�ISPo'r� �
Si sewer'
Fri artYAef�bme r_+tCt. O�Jer 0r ��j�
fJa p t i `�o! ! '. ,+ % F/h�'of 1YP j(v ,e. n
9 dress %` 1 la
/c/0,4I/
i - �� -.. BAdss
/ - laO -O '77S lly/5 are/Zip SZ y
PelephoreNumber!email address _ Z j 7 3 7/�
"74j(� `-,�/� ")n I elepn ne[lumber/ert addI.ass
Dc2 D r 2 .7n2 o
Valid for one calendar year after signature`° (Revised Aug 2094)

• E
:
,l
Toby Tetterton
i
i
r
From: Mae French <[e-mail]>
Sent: Wednesday,April 15,2020 12:18 PM i
To: TobyTetterton I.
Subject: Fwd: Form from French's
I.
fi
Sent from my iPhone
Thanks
s
Bob
Begin forwarded message: d
From:Judy Davari<[e-mail]> j
Date:April 15,2020 at 12:15:32 PM EDT
To:Toby Tetterton<[e-mail]>
Cc:Mae French<[e-mail]>
Subject:Form from French's
i
i
Ct i '„r`s, -'C "',Y'`'t+s - ati ii”i :f r' e' t '"'" F" T ` a a ,,3 y n' ' y;' i
{ +7 R i b u#n 3 d `t b .}V & # d .h"'4 Y '' t # . �. i
k. tr * i.01 } v 8 r`J""+rh �'Po'ff x it '' is f q ''ti a u
4, #'> -fir fy , a'8Y°a i 4 5i "" #' ip )
f r. { y t S s,r A1` t r „.. s I ? a'i �' `5 i.� ,$ �-t t r`y
i.
t Y t FiN i 2"4 - _ P9 f ay, .1 r z "�Q s w .k,I,s g 3
3 34 �� d' te. �g,` va , t t .W zc�4e £ef at "x.., ' '� 3 t`
IS"1- y •,,•. 9t t mmti"%v A, 1., a q tak,� -;: a.,
11 '� ! x+a.. t c C4 c. x. to
t 4.. i F • r t 4 , ,adekf-y y ' y ys ` kd 't�� ?y7
OhLi
-as „'i. t '.�`r 3 ti ' • 8 r° 19' �`. ig,r� d�'- � -f44- aJ- '•,:� }f:7 t. ,t, ':7mn ..g �S.1: ,-^.j 1`
Of tg ak, �t SF`� -5 i t "'}"y s a ' 'i'" .k h ^,N " i4 y77;} as ,} " gyp .' I
X4 f44 5 , ;11 *M i u g`Iyit §'.2 iget , V, i. i, 4" N 45 I
' -, ' 1 hti �,4 k.t.+y' l' :r . A S„ ; PPP i,jz " y k ,
r',tti 'z 45`. - . ,k. f s.. 1..-...: ..,., ... }y. - 3 i
a, -t #Go- " ",R `„ `� i yy A. ', tr 'gyp` #+fir3a{ {
'c..S:. A _.,�.u,d st,. 'k.r.x,,.,,, ` .t';°. ..fiu. .i ....._s�P...!w...?,_ sa:�._is,_�s...�.. ,x..:.. ,
i
I

Toby Tetterton
From: James Holland <[e-mail]>
Sent: Wednesday,April 15,2020 I:18 PM
To: '[e-mail]
Subject: Adjacent Riparian Property Owner statement
I have read the Adjacent Riparian Property Owner Statement and have no objection
to the proposal of adding a 16X16 foot platform for the construction of a gazebo 4
at the property located at 164 Catnip Point Road, adjacent to Bath Creek, in
Bath, Beaufort Co. N.C. In addition to this e-mail the original document has been
signed and returned in the self addressed, stamped envelope provided by mail.
James E Holland manager for JMBL LLC, owner of the property located at 162 Catnip P
Point Rd.
Sent from my iPhone
s
IF
1
{
•
1

, . ----
, 71 741/‘ ; 1, v
, /6\Z
M - •
o ic) 60 v S .± .,
-, /-n
M !
rY, !J
1 I, \r r 4 „I , / ii '
(I h J G nt
I V' v I
p . „1,, .4. (. \.1) /
r
r
t9N A (-'
o_ c, !0____a_ __\?, -
, J x f
r-- rz
( ;•\1?
9
t .L . zT

: i
�,_._

NC Division of Coastal Mgt. Habitat Impact Computer S4ieei
t
Applicant:S}!t fl 4 dun i-r'-1 DA NAR
Date: 1-2 A P'2 t L z o z o
General Permit#: —7 5-3`7 8 — f3
Describe below the HABITAT disturbances for the application. Ail values should match be name,and units of measurement
found in your Habitat code sheet
TOTAL Sq.Ft FINAL Sq, Ft TOTAL Feet FINAL Feet
(Applied for. (Anticipatedfinal (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance Disturbance disturbance.
Habitat Name Choose One includes anyExcludes any total includes Excludes any •
anticipated restoration any anticipated restoration and/or
restoration or and/or emp restoration or temp impact
temp impacts) impact am cunt) temp impacts) amount)
ot� '
W 4-re". Dredge❑ Fill❑ Both ❑ Other Q 2 54, �k2 r
r
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other
Dredge❑ Fill El Both El Other ❑
Dredge❑ Fill❑ Both ❑ Other 0
•
Dredge❑ Fill❑ Both 0 Other 0
Dredge❑ Fill❑ Both ❑ Other 0
Dredge❑ Fill❑ Both El Other ❑ •
Dredge❑ Fill❑ Both 0 Other ❑
Dredge❑ Fill❑ Both 0 Other ❑ •
Dredge 0 Fill 0 Both ❑ Other ❑
Dredge 0 Fitt❑ Both ❑ Other ❑
Dredge 0 Fill El Both 0 Other ❑
Dredge❑ Fill❑ Both 0 Other 0