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NC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant: L' �C
Date: 12'�6
Permit #: b-7g50 1
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremer
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet I FINAL feet
(Applied for.
(Anticipated final
(Applied for. (Anticipated fin
Habitat Name
DISTURB TYPE
Disturbance total
disturbance.
Disturbance disturbance.
Choose One
includes any
Excludes any
total includes Excludes any
anticipated
restoration
any anticipated restoration and,
restoration or
and/or temp
restoration or temp impact
temp impacts)
impact amount)
I temp impacts amount
G
Dredge ❑ Fill ❑ Both ❑ Other
7
J
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 ❑ Other ❑
Dredge ❑. Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill [I Both [I Other El
Dredge ❑ Fill ❑ Both 0 Other ❑
Dredge ❑ Fill 0 Both ❑ Other ❑

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