57439D - Davenport

' CAMA / DREDGE & FILL
'3ENERAL PERMIT Previous permit# r�Z
New —,Modification ❑Complete Reissue - Partial Reissue Date previous permit issued
sized by the State of North Carolina, Department of Environment and Natural Resources 7
Zoastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / 4 _ Lt
BAules attached.
it Name d / rl Project Location: County AJ&LU IC i,
11 4 H 12j1� (_l#41 '_ " 7 Street Address/ State Road/ Lot #(s)
J� l�1-- State_ZIP ' 25 I k;'Uu L
-7 71-1 Fax # ( )
:ed Agent t Y�� � !c' 6-t- a {.. ;fi C G.
CW SEW PTA ES ❑PTS
C OEA ❑ HHF IH . UBA J N/A
C PWS ! FC:
yes / no PNA yes / no Crit.Hab. yes / no
Subdivision
City (>? 1 S l..fi6V�� ZIP
Phone # ( ) River Basin LVM
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f Project/ Activity t.� i !, c t r-
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distance offshore
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ng permit may be required by: ❑ See note on back regarding River Basin ri
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�,QNT RIPARtAW vttnera"v
A3 I U W N?*,P 11 ti I I I PTr` A'rTn►
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Name of Individual Applying Far Permit: � mY .�—
M : �
Address of Qr�pery
ea
S:reet #, Sheet or
�O 71--slaA�,
and Counry,,
;;crebv certify awn property adiacent to the acove-referspiope;� The ind
applying for tf.is permit leas described tC me as shown on the amctzro dra,,vir�
ire RTOnosing. A description or drawing, with dimensions, sho��;d . —0 „° `nc develOpm,
- de_+ with this It
have no objections to llr s proDose.
11' yc': have objections ro %vilat is being proposod, please wrtre ti1c Uof C
Management, 127 Cardinal Drivo Extension, Wilmino ort, NC 'y;if;S or c:,jl 791
wttbia 10 days of recciptOf this notice. No response is considered tl}c some as ,,`,
�•cu huve been nod ied by Certl!lcd Mali, r °bin
WAIVER Sl M011,
1 understand that a pier, dock, mooring pilings, brenlovater. ooa :.o�,e or t)o;,, z bck a n?lnimc:ni distance of �' fr , ,
om my area of rips rion access . u niess �� must
``i`b to ►�'ci�'e the Setback, you must initial tho nnnroDriote
ve I
doy✓tSt! to 1V8iV4 the 1: SC:Is�:f� rC�Ci•o,._`_
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)Qlicadt: —
ite:
Permit #: S-13 q
!scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremei
ind in your Habitat code sheet.
bitat 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 fir
disturbance.
Excludes any
restoration anc
temp impact
amount)
C L
Dredge ❑ Fill ❑ Both ❑ Other_
I
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 ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill 0 Both ❑ Other ❑