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HomeMy WebLinkAbout75356_Thomas G Irons Jr_20200727 v i -ro4 w-r-1 Q - CANIA I :DREDGE A FILL GENERAL PERMIT Previous permit# Flisiew Dflochfication 1. Complete Reissue EPartial Reissue No. 75356 A C Ca+ ' D' ri h3 Date previous permit issued As authorized by the State of North Carolina,Department of Environmental Quality arid the Coastal Resources Commission in an area of environmental concern pursuant to ISA NCAC ‘;1'21-1' ;Whiles attached. Applicant Name•*-17)zsi.4.43 ,e.s-4 . T.•*-Aca.fris. ,74„, Project Location: County_ Zer44,4r,4er3---42, Addressj '0404ei4ipigiP Pa-- Street Address/State Road/Lot#(s) /r d'zr <11*: City 4 A42r14?ketio-Liq.- State lie ZiP t.s5, a hi-' --tes /.0.•... T-'----0- — - Phone#( ..,) ; E_maulf,.L*i We;letiM.co.,4e,ii,eVseZubdivision 7/3pc 4,..ta--,-.* Of 3 001.re%a„caw. Authorized %lent;"..e.siftiTtmAs. tas,11$1,„WL4111..,* City5e*1,* ZIP `747-28-‘)fr Aff OCW yaw .WTA -EES OPTS Phone# ( J___ _ River Basin'-`174er-Avt.--4(0 ected 1210EA CFNFIF b 114 ELM OPWA AEC(s): Adj.Wtr.Body?..04.-0,44‘,0 giad-eze., la titan /sedin) 0.VW& 941444 4t sesj. tr. P 1 ORW: yes PRA yesir ) Clot Ma Wtr.Body 1 i 4 Type of Project/Activity ;3 x 13 1.44Jeoc,4;024-,- p i . (Scale:I z-2,o ) Pier(dock)length_ ). ",-7 i ....7.. -$-. li '• • • fl•-r-i 1 i Riced Platiorm(s) r i' . .-, :- 4 -!:, rikiiA.4(ioi -i..".fu-1..;, ,-- - - .1ht-f-7"--- "1'.1--t-±-i-1-71--t-T-I-'1' Floating Platform(s) 11 I inger pier(s)F r• . 1.- : .: 1 i :.: , • ,?, 4-f- ---t---14-1-.7-4---1-1-i-j- t; - ' i ' • .. ;. 1 - 5 ' +1-4-5---i.----Vz6. -- 4;---4----4-1----4:.--i--f- . Groin length 5 44.4*( 441. .407' i 4—.4- ' '- 1 ' ' t i • i , i f 1 , number ' ' 4t: _"..• '. . 1 4 --' -.:- i, i 1. . . T-•, , ,•• ..,-3, , 1 f kt --i 1 i If .-- : ' ! 1 . : r•••'.!• i. 1 4 4- Bulkhead/Riprap length_ -I . - i•-• • i i .! • f J.. - . :. . L ' , avg distar.ce offshore I .! ;: i - i: : ;-. ; i : . I :: : - ; "; ; :: I -.-- , . I 1 :- .- . t;;;,-; i 1- ••--•-i :. ,1,•-i•-•-i- max distance offshona f- i if 4---."' -; it- 4'•"„ ' -4--i" 4-'; "*-- 4 i . i Basin,channel .t- -4 -i :: 1 .. 4-4 i •': t ' ' 1-- 4' J..--4•-••+-1--4-i-i----f-t---i---4.,.."0. .,= .. , _.... -I. . : .i...-...: .,i..__ ..-4 . %----1- '.. i--,-- . i _..i....._.L....4_..i cubic yards ‘• -.....1...:;:. ',. I. ......L._.L . .....,_LI ..,,. J. ..:„.1. I i .H '. . LI i ; i L ,_.4" L ' ' ' ' ' ' ' , , ',. I -1---1 --1. 1 .• -1„—r-JO:', :, ., _i..._.4._. 4-4_, Boathot "-- 1 .14. t; , ,. I ..:, i ..,,_.4 •i [2_Y t_13.' r ; r-1.1. ,:- , r.. 1 :,•,-0)69,1 • . -1- i -4--'.-- i 4-4 ' ' t ! I. ..-..-1- I I 1""t"•:- '.!• 1.--t---, . 1. 'f, -1,- . ? ,,,,01 , .,., : ; ; 1 ...4_.' 4...... i 1._1 1 ?. ....i. 1.....1.....1 -i : `i. :', ?.: i 1 1 J., ..j j f •Beach Bulldozing _ . 1..--::. -rt. .;; I i '',- 7. f--; 1---- ---1--1.7-1-------,---,---r-T-- --1 r - ,--i--;---1-1 ,...4_, --1.--, -.,----±-,--.1 Other_ _, .__, ._.. 4 ,,,. ', ,; ! i 1- , • • , , , .. 7 T— t.....,.-,-, --,--- •kri- .: ' ', f : -4- 4- '4:—l'. 4- —"f"--4--4.--4— -'• ; -i-f----+-4- 4 ;'-'. i L.,.' .1...;: i_f ; -- , - 1 : : :, , 1, . 7 I 1 + ' '... ; ;' .!• :, 4 -i• - --[!. 1 ;- -1-•-[4.---1.--4 '•[ i Shoreline Length SAV: - 7-1-- -----1-.7"-- • f 1 t-1--"'"rt-t : -t 1. I not sure yet['''.. J. ! .. i •[[ -. • • 1. '.' ' ,. ... . : . : '-, '.... 4... 11"w)cum: nl,a,.......)yes D7.1.......,_. .1, . i.....„, -'#!. Photos: S9 Waver Attached: t „ „ . , . --1I1i- L i I i A building permit may be required by:Irtmi4sos.riavi 1"--.Ilt,• . j•See note on back regarding River Basin rules. (Note Local Planning)urisdiction) Notes/Special Conditions i [,. . . t:Ncirti 114 6•J 4-1.-7-- ,i/e/t.- 'SP't"ei-7, _ .. Agent or . Primed None P * s Printed Name • a _____A:-Q0-ti- L2fir-____ _ • . "Please readcompliagiestaternenten badtaipertnit" S. patkl•v. .-.. -LOD '-" i/411( -2 2.:7___ Ie.-€) -----• Aplicaticolgee(s) Chedt# issuing Date Expiration Date I i t [• •[ . 0 1CAMA/ 1❑DREDGE & FILL No. 75356 A ® C D GENERAL PERMIT Previous permit# : IA )C jtiew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued ,.) ,,- As authorized by the State of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 44)7/' ' Rules attached. Applicant Name ''�i.JDMPr3 la. ��r15 ,Tie- . Project Location: County Beici.fr, to Address / 4i- �,�1¢Aniek,ic/P— PE-- Street Address/State Road/Lot#(s) b� s� /21)-{p City 4$i>?Lr-})vi1-ice- Statei,1G ZIP 'Z^7Fj5''�' es /ii ' a ri-,EitAl 7Z-,..49 • Phone#( ) E-Mail n c.w,"r"^r_cx.'^1-1.rM c ,b-Subdivision 1:34)yvi&r`4" Ur 3..Ng0 1. Gew Authorized Agent :Jv �o 4.4..15.3- : 2 9,71 /9- City T ^nt ZIP 2-715-1> r" ❑CW yEW yritpTA ❑ES ❑PTS Phone # ( ) River Basin P44'-1e-0 Affected ❑OEA ❑HHF 51 IH ❑UBA ❑N/A AEC(s): Adj.Wtr. Body" u ed ,1. 401 man /unkn) ❑ PWS: ORW: yes �/ PNA yes ino)) Closest Maj.Wtr. Body ��'��'LA "''�` Type of Project/Activity l3 X /3 u L/Lc3 vt29e-49 r r ; - 7-,l '' I (Scale: I =2 ) Pier(dock)length I �� _J 1 1 1 ' I Fixed Platform(s) & T N e o` 1 v -mot Floating Platform(s) I Groin length �l'1lrl 40) 0,1 T - ' Finger pier(s) i I gt i 3 )'t '�1�$ number I '� t. r-► ect-t�1.-e0 j Bulkhead/Riprap length j f ^ 150• 1=1— I ) -- I avg distance offshore I L I max distance offshore r — • I I ,_ Basin,channel 1 { 4' cubic yards I ' _ T— t t !�_, j Boat ramp I r 0 p j 1 Boatho Boad t ! f If , i /3 k / 3 ' E I I ._.. p)- Beach Bulldozing I I (/q4 1 Other I I Shoreline Length t 41,1 SAY: not sure ye.< Moratorium: n/a yes no "P zir r 1, G�,S P I e Photos: es ) 42.12.1.10 j L. S l.. crab( Waiver Attached: yes no I I I , _ _._ A building permit may be required by:' q.i 1�srt,7'T An,• . / 4 See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) Notes/Special Conditions / GL/ Spivt•-.L7 Agent or Applicant Printed Name Perm' fficer's Printed Name Signature **Please read compliance statement on back of permit** Signal r pal?rti,L `Lot) "- - I S3 ` -2/ - /20� ///-7 / ri Application Fee(s) Check# Issuing Date Expiration Date r Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action;and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian landowner(s). The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief,certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: Tar-Pamlico River Basin Buffer Rules P1 Other: Neuse River Basin Buffer Rules If indicated on front of permit,your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office(910-796-7215)for more information on how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ 1-888-4RCOAST 252-946-648 I Fax: 252-247-3330 Fax: 252-948-0478 (Serves:Carteret,Craven,Onslow- (Serves:Beaufort,Bertie, Hertford,Hyde, North of New River Inlet-and Pamlico Tyrrell and Washington Counties) Counties) Elizabeth City District Wilmington District 401 S. Griffin St. 127 Cardinal Drive Ext. Ste. 300 Wilmington, NC 28405-3845 Elizabeth City, NC 27909 910-796-7215 252-264-3901 Fax: 9 I 0-395-3964 Fax: 252-264-3723 (Serves: Brunswick, New Hanover, (Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet- Dare,Gates,Pasquotank and Perquimans and Pender Counties) Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 r_iCAMA/ ` DREDGE & FILL0 No. 75356 A C D GENERAL PERMIT Previous permit# ,, ,, > ❑Islew El Modification III Complete Reissue El Partial Reissue Date previous permit issued r , , As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC e... 7 f1 /20‘7 . WI Rules attached. Applicant Name Jc/"'A3 Cs4 - . '- __,),...Is ,S',e . Project Location: County .yr ,i-, ,--c Address / I' ?,.clo ►Mo/fc- f E Street Address/State Road/Lot#(s) &fl Paz /-4 j (4 City .a f440k-7-1 4,,44,c State ) ) ZIP 2:1 /ii ' SA 'v/ i.zo Phone#( ) E-Mail �} -\" 'r` v`c. u . �-1 r , -� Subdivision yv,E-•--' Authorized Agent ...--ID f►,_) � -ti.o� -A. -�s- -,oy '3 -I� !� zs'2,9� •� City/3,- -7-7-1- _Z.�ZIP FSOr-- Affected ❑CW 9•EW yeTA ❑ES CIPTS Phone# ( ) River Basin TAw- atI AA i e• 0 ❑OEA ❑HHF ❑IH ❑UBA ❑N/A AEC(s): Adj.Wtr. Body /�n,,, ,e-v L 1 i, �ar�/man /unkn) C PWS: ORW: yes / ng PNA yes no) Closest Maj.Wtr. Body 7�^`'/0 "'� Type of Project/Activity , y 13 �1 i/ r.4..,-1 tY� -7Z,-'T r , (Scale: ) _?� ) Pier(dock)length _ - Fixed Platform(s) ! 4"— nn� �'- ��) tr-i Floating Platform(s) l Finger pier(s) Groin length . E1Nr15+1+4ti 'e WI f . I ray1^1.I Z * 4 r"3 number j .W4?FlastkM�'—I, 1 V.rl-"Duett te7 _ Bulkhead/Riprap length j '• Dr—rt. ' T ' avg distance offshore N max distance offshore Basin,channel I I i 1 .b cubic yards a l' r • . Boat ramp .'1 0 Boathoii.ip/BoatJift ; Y4 / X / 3 r'l&fir 4 l (A)17. ) Beach Bulldozing - i Other f ) ,0(1 1, -t-, Hz, Shoreline Length f 4L,./ SAV: not sure yes'n9 — --- i IJVw(.. # �.._._. Moratorium: n/a yes icp, -pr76-- r P, e-¢ ,S Photos: yes igalao ,,,guys C.. •-'11 3""-i 1. - ' Q' I Waiver Attached: 4gral, no — 1 ' A building permit may be required by: larve4.4.1Zvi-f-- e/-p. . See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) Notes/Special Conditions `, r _.,, 1 , , I Agent or Applicant Printed Name Permit Officer'slPrinted Name / _ -- Signature **Please read compliance statement on back of permit** Signature . "•- pGPGln .- 21)17). r / / 5 3 ,I7' • / . , 1 i /` Application Fee(s) Check# Issuing Date Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian landowner(s). The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief,certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: Tar-Pamlico River Basin Buffer Rules I J Other: Neuse River Basin Buffer Rules If indicated on front of permit,your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office(9 I 0-796-7215)for more information on how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ I-888-4RCOAST 252-946-648 I Fax: 252-247-3330 Fax: 252-948-0478 (Serves:Carteret, Craven,Onslow- (Serves: Beaufort, Berrie, Hertford, Hyde, North of New River Inlet-and Pamlico Tyrrell and Washington Counties) Counties) Elizabeth City District Wilmington District 401 S. Griffin St. 127 Cardinal Drive Ext. Ste. 300 Wilmington, NC 28405-3845 Elizabeth City, NC 27909 910-796-7215 252-264-3901 Fax: 910-395-3964 Fax: 252-264-3723 (Serves: Brunswick, New Hanover, (Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet- Dare,Gates, Pasquotank and Perquimans and Pender Counties) Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 e -,-. • CAMA/ ❑DREDGE & FILL No. 75356 GENERAL PERMIT Previous permit# A BCD >Z ❑New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued As authorized by the State of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC D Rules attached. Applicant Name Project Location: County , , Address Street Address/State Road/Lot#(s) - City State ZIP Phone# ( ) E-Mail Subdivision Authorized Agent _-% , , ., , s,,.,� ;c,- _ r City ZIP )iS.::=+Tf' Affected ❑CW DEW Q PTA ❑ES ❑PTS Phone# ( )_ River Basin " ^ : 21. - AEC(s): ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body (pat /man /unkn) ❑ PWS: ORW: yes / no PNA yes / no ' Closest Maj.Wtr. Body Type of Project/Activity (Scale: I ..,,.) ) Pier(dock)length I ; Fixed Platform(s) I Floating Platform(s) , Finger pier(s) 1 l Groin length I -`,. , -, t, , ..+,a•., / e y L number f r': . t •�',. ,I_49t I '- r c ) Bulkhead/Riprap length / Fi:a t s ` avg distance offshore max distance offshore I �, Basin,channel 1I cubic yards • r '• - ' ' Boat ramp i 'R i kJ', Boathouse/Boatlift - Y C t • J/c,+f' Beach Bulldozing e , Other F.a9 e. r' ---;.!?) l Shoreline Length - ; SAV: not sure yes nai -1- -- i lU 4 llama.-_.._ _-.. Moratorium: n/a yes l no1 t477 e— r• { f) ,? , - Photos: yes-"-lib „, y' L Waiver Attached: - yes no t , j A building permit may be required by: j . � r r ;7Ts,.• . See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) Notes/Special Conditions Agent or Applicant Printed Name Permit Officer's Printed Name Signature **Please read compliance statement on back of permit** Signature ,.. 0�k .-) L ` -- Application Fee(s) Check# Issuing Date Expiration Date Statement of Compliance and Consistency This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian landowner(s). The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available information and belief,certify that this project is consistent with the North Carolina Coastal Management Program. River Basin Rules Applicable To Your Project: Tar-Pamlico River Basin Buffer Rules Other: Neuse River Basin Buffer Rules If indicated on front of permit,your project is subject to the Environmental Management Commission's Buffer Rules for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office(9 I 0-796-72I 5)for more information on how to comply with these buffer rules. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave 943 Washington Square Mall Morehead City, NC 28557 Washington, NC 27889 252-808-2808/ I-888-4RCOAST 252-946-648 I Fax: 252-247-3330 Fax: 252-948-0478 (Serves: Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde, North of New River Inlet-and Pamlico Tyrrell and Washington Counties) Counties) Elizabeth City District Wilmington District 401 S. Griffin St. 127 Cardinal Drive Ext. Ste. 300 Wilmington, NC 28405-3845 Elizabeth City, NC 27909 910-796-7215 252-264-3901 Fax: 910-395-3964 Fax: 252-264-3723 (Serves: Brunswick, New Hanover, (Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet- Dare,Gates, Pasquotank and Perquimans and Pender Counties) Counties) http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17 NCDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Michael F.Easley.Governor James H. Gregson, Director William G.Ross Jr..Secretary Date 1 6( Z 0 Name of Property Owner Applying for Permit: ,--4 {no✓��c G a(-c Mailing Address: r ee r,(J+11 ° � c- I certify that I have authorized (agent) -)o" n �a �`, to act on my behalf. for the purpose of applying for and obtaining all CAMA Permits necessary to r install or construct(activity) 00.1- at(my property located at) t ���U 1 e J p� ) &.1L. } t�C ( Ut 1 Z.OLI This certification is valid thru (date) )//1672 c)?P Property Owner Signature Date 400 Commerce Avenue, Morehead City, North Carolina 28557 Phone: 252-808-2808\ FAX: 252-247-3330\ Internet: www,nccoastalmanagement.net An Equal Opportunity',Affirmative Action Employer-50%Recycled',10°10 Post Consumer Paper { ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to F\cA 1'`�`�r' ��"t" � '� 's r (Name of Property Owner) 1 property located at i a II (3c i .) ,e w 1�-tJc; Lot Block,Road,etc.) on �c_r.. I. i;P R:.-�! ,in ge.,- . � ,N.C. (Waterbody) (Town and/or County) He has described to me, as shown below,the development he is proposing at that location, and,I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. I do not wish to waive the setback requirement. I do wish to waive that setback requirement.✓ DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) De r-,o \ e s(1 ci r A r t'-b ,..) t 1 Act 0 -1-- \ .4:1_ ,..,-,-11, 0 e g......, ,e', 1 ,",:),s ....)-- 1,-,o (;Dor 1 s 1 -1 3 1,,,,,-r(..i Signature �,//,a.-". 6. " e(e -<- Print or Type Name Telephone Number Date: CO . g• .A C) r . ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOUSE) I hereby certify that I own property adjacent to rvmot' 's (Name of Property Owner) property located at \ (Lot,Block,Road, etc.) on mac., !' ,in Bc.,'t"k ,N.C. (Waterbody) (Town and/or County) He has described to me, as shown below,the development he is proposing at that location, and,I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by me. I do not wish to waive the setback requirement. I Lk wish to waive that setback requirement. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) } r ,� , cSt sp,e,,1 -1 Sigo ure 11 Lynn i4 . Cris Pritit or Type Name p- - ati R4 lS Telephone Number Date: 6 - It- 0-0a0 Existing "t" on pier New boat lift to replace existing boat lift, in same location. Will be narrower ("10 feet,) so will reduce overall footprint. R . fisting Boat lift (approximately New boat lift outlined in red 13.5'wide from 110 edge of pier) Pier • ) I'l NC Division of Coastal Mgt. Habitat impact Comp-ate r Sheet Applicant: / /�o/Yl A S 6. 7TiZo t. s 7 Date: 1/2:: acb ZO General Permit tt: 7 J;s40 E Describe below the HABITAT disturbances for the application. All values should match be name,and units of measurement found in your Habitat code sheet TOTAL Sq. Ft I FINAL Sq. Ft. j TOTAL Feet FINAL Feet 1. (Applied for. (Anticipatedrinal (Applied for. Anticipated anal DISTURB TYPE Disturbance total disturbance. Disturbance ! disturbance. -iabitat dame Choose One ncludes any Excludes mry total includes I Excludes any i • anticipated restoration any anticipated restoration and/or restoration or and/or ern restoration or temp impact I temp impacts) mpact am cunt) temp impacts) amount) W Dredge❑ Fill❑ Both ❑ Other M/ � .. II � Dredge❑ Fill❑ Both ❑ Other ❑ I I Dredge❑ Fill❑ Both ❑ Other ❑ I i i I t Dredge❑ Frill❑ Both ❑ Other ❑ ' I Dredge❑ Fill'❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ redge❑ Fill❑ Both ❑ Other ❑ i I I I c '-I Dredge h Rif❑ Both ❑ Other ❑ I I I { Dredge•.] Fill❑ Both ❑ Other ❑ Dredge J Fill❑ Both ❑ Other ❑ I j i I Dredge❑ Fill❑ Both ❑ Other ❑ Dredge❑ Fill.❑ Both ❑ Other ❑ I j Dredge❑ Full Both ❑ Other ❑• Dredge❑ Fill❑ Both ❑ Other ❑