68013D - McNamara

NAG Division of Coastal Mgt, Habitat Impact Computer "t
r�_ Permit #: 6��/�-/>
Applicant; ��� r v! / 1�/' ll /l
Date:
Describebelow 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.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
IPI
(Anti
dis
Era
re
an
im
Dredge ❑
Fill ❑
Both ❑
Other
LO
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill Q
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge Q
Fill ❑
Both ❑
Other ❑
Dredge Q Ril ❑ Both ❑ Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge Q Fill [] Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
r - )-- rr Gin r`t Re)fh M Other ❑
`,L Sq. Ft.
TO ] AL reef
for.
ruvn" 1 —
(Anticipated final
;ipatedfinal
(Applied
lurbanoe.
Disturbance
disturlsance.
lutes any
total includes
Excludes any
and/or
5bration _
any anticipated
restoration
temp impact
Yo,rtemp
restoration or

'ayment Proccessing Confirmation
)ate Received 1/26/2017
heck From (Name) Coastal Marine Piers Bulkheads LLC
lame of Permit Holder John McNamara
lendor Wells Fargo Bank
:heck Number 21283
:heck amount $200.00
Multiple Permits No
Major/Minor
'ermit Number/Comments GP 68013D
teceipt or Refund/Reallocated SF2635D

■ Complete items 1, 2, and 3.
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1. Article Addressed to:
I S�� Lah dolt /mot., c.
d". f +�.C, 3gU�2DCM
A. Sign�tVe
❑ Agent
X/ 6(J ❑ Addressee
B, ceived by (P i iqd e)- C. Date of Delivery
D. Is delivery add4i diff nt from` Rk.1? ❑ Yes
If YES, enter deliv address below: ❑
CEIVED
MINGTOP(, NC
0RPriority
III�III'IIIIIIIIIIIIII
II III
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"Av,
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egiseredMaITMess®
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9590 9402 2341 6225 6351 08
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7 016 2070 0000 1743 2606 sured Mail
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sured Mail Restricted Delivery
Restricted Delivery
i (over $500)
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
IN Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
nr nn tha frnnt if cnar:a normitc
��3� �►� LaSI� �.a�
till
11111111111111111111111111111111111111111111111111
9590 9402 2341 6225 6351 60
2. Article Numuer (iransrer rmm sere
7016 2070 0000 17
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Merchandise
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nsu red Mail Restricted Delivery
Restricted Delivery