67949D - Gunther

NC Division of Coastal Mgt. Habitat IMPact Co;r><mputer Peel
Applicant:
Date:
Permit ##:� f
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,FExcluddes
et
(Applied for.
(Antpated. final
(Applied foc .dfinal
Habitat Name
DISTURB TYPE
Disturbance total
disturbance.
Disturbance .e.
Choose One
includes any
Exeudesany
total includesny
anticipated
restoration
any anticipated
and/or
restoration or
andlortemp
restorationor
ppt
temp impacts)
impact amount)
temp impacts.
amount)
Dredge ❑
Fill ❑
Both ❑ Other ❑
cuu
Dredge ❑
Pit ❑
Both ❑ Other ❑
Dredge ❑
Fill ❑
Both ❑ Other ❑
Dredge. ❑
Fill ❑
Both ❑ Other ❑

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