62574D - Daughtrey

CAWIA / DREDGE & FILL _ / N K
ENERAL PERMIT yyy Previous permit #
— New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued 71
rized by the State of North Carolina, Department of Environment and Natural Resources L
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
OR I attached.
t Name ✓A Project Location: County V (
UZ Street Address/
State Road/ Lot #(s)
State EV - ZIP-4--
Rio ZG l _'i 16 J Fax #( ) Subdivision
zed Agent Ag �� _ 60 City G. �'L./ / (1 —tT ZIP
d CW , ; EW ( PTA �ES ❑ PTS Phone # ( ) River Basin
OEA HHF ❑ IH ElUBA ❑ N/A Adj. Wtr. Body c--� 1%y� i_� n f (Alhat
yes PNA yes no) Crit.Hab. yes QJ n� Closest Maj. Wtr. Body
Project/ Activity
lock) length
pier(s)
length
lumber
ea4PRiprap length -'4 /da
ivg distance offshore
nax distance offshore 'Lt+-+
channel
:ubic yards
amp
Ouse/ Boatlift
Bulldozing
ine Length _ notsure yes
ags: not sure yes
orium: n/a yes
yes fLffW -- !- -1—'
r Attached: yes( —
ding permit may be required by:
6A ; A-4 l /
4 .Op.t [.
(Scale:
_' .L �_ %� ❑ See note on back regarding River Basin

plicant: 'j�E / ._� { Permit #: 60 z
fe:
jb_Z13
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
Oat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance_
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill
oth ❑
Other ❑
160
Dredge ❑
Fill ABoth
❑
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 ❑
Both ❑
Other ❑
Dredge 0
Fill ❑
Both ❑
Other ❑

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