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HomeMy WebLinkAbout74131_Ed Waida_20200803I AMA/ 11 DREDGE & FILL ��'-S No. 74 13 1 A C D 0GENERAL PERMIT -. W�(0C1/7 Previous pe,mit# ').-.) new ❑Modification ❑Complete Reissue EPartial Reissue Date previous permit issued 1 f� 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 SA NCAC P-7 N ' 1 emu • -iiitules attached. Applicant Namea''D Age1/z).c4. Project Location: County_13. Address /DGo, P 5?l2 -7 Street Address/State Road/Lot#(s) /v 4.. .c:› pJr-s City /-4•4 ^t o!`L State 4 G ZIP -277 'g.1 --- Phone#(.2C2 .) b E-Mail -pq i'ol� @ Subdivision- / a,1 v ..✓-h -,,�-4r -fr-7 o Authorized Agent I �� RAG,r.,�s� �� Clt -T-z. ZIP Affected ❑CW DEW TA [7ES ❑PTS Phone# (_____). _______ River Basin-211.--alliac_L J ❑OEA ❑HHF Li IH O UBA ❑N/A AEC(s): Adj.Wtr. BadyjQeA4c7 G4 ng man /unkn) ❑PWS: ORW: yes q � PNA yes no_....--- Closest Maj.Wtr. Body 'i ? �"l ::) - z- 1 Type of Project/Activity /^2 yq/a �t v�rj7A..)Lj ? ,m,. z`. .C:c X_ _ (Scale: iA� ` ) Pier(dock)length —,__._.__.__,- Fixed Platform(s) --L- Floacing Platform(s) -,!/Z - -� &� � �^�,, - ' ` ` - - I %gerpierCs - T Groin length _ 4- 1 number - _ - _ ._ _ Bulkhead/Riprap length _ 111 - - 1 _— lrY1;j�PA -� �_ 39: avg distance offshore t max distance offshore *--lei. _ - fie. � - - Basin,channel _ .— - I - , 1 l r cubic yards - - - - ,-- r-' ' t •••-_,,___ , 1 ! T , Boat ramp �;I" i Boathouse/Boadift '-1 --- --- -r lqi Beach Bulldozing Y L s, JOlie IL? ... �� Other t, .a. i — —---; - -- --__—_ __ 'SIX . l Ile Shoreline Length ZcS'L� r.4-- . all SAV: su yes no i -------------- i.., Moratorlum; n/a yes ....._ T r- _ _-__-__ Photos: yes ` no - ��� - Iz� . 1 r` _____ Walve_rAttached: yes no T. ---- A building permit may be required by: , Q-r-r " 71--/e)" - . See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) Notes/Special Conditions C:104",u-'ca 17 'r+''tv4'T-7o1J ep g.,b 1-i-i di 141-. / t7 2 -/1-t__ lez tv-- — - 111111110.101.111MMEMMINSOMMINI MOW Agent or Applicant Printed Name :" Perm) Ofilmes Printed Name Signature a read compliance statement on back of permit" Sigtet'txb-' '" --Gl t•he. AI'Zc9©'' f8'7 „..5,zl�r,yzr,s- -24,--„,--4., _3 Z772"• 26'2_c) Application Fee(s) . #. Issuing Data Expiration Date :.. _ 0 AMA/ DREDGE & FILL No. 74131 A C35 C D ENERAL PERMIT Previous permit# 14 YN- )C ' New 1-,Modification Complete Reissue J Partial Reissue Date previous permit issued I.1 )A 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 i2 7 Al ' 1Z4°4-2 . JR:Rules attached. Applicant Name ED k A/27/--j. Project Location: County -j r� f9-A-fr7- Address / O(p j> ? 'T Street Address/State Road/Lot#(s) I o p 5,,, jr-dr' City brit154`4 ijt-o r State 4 C- ZIP —2. 7f'$1 Phone#( ) $ -60475 E-Mail ;dot @ • �� Subdivision do ' h/ ir4-77p (� Authorized Agent I.1 IA City) /i J z rbD1 ZIP 2'-71,t I Affected ❑CW ElEW 'TA ❑ES ❑PTS Phone# ( ) _ River Basirr7 -6 �t ( J AEC(s): ❑oEA ❑HHF ❑IH ❑uBA El WA Adj.Wtr. Body0v.. G� rciiiman /unkn) ❑ PWS: ORW: yes�� PNA yes Kip Maj.Wtr. Body7v�'� �)✓6-yt i I Type of Project/Activity p2 /2- ./ J(J17.t..14.1 J7 /ti. L. i,� IL (Scale: I ='7a ) Pier(dock)length Fixed Platform(s) - Floating Platform(s) /2 74/Z 6. ' talz. wrt-- RAge`P Jr j i--- Groin length I _ number I Bulkhead/Riprap length f L J�wG L 'z,) Doc-/-- avg distance offshore i S'-7' t N max distance offshore V` $7..4. Basin,channel ( S ex try, r� pLti� _1 f ' --- cubic yards ._.-_ 2 Boat ramp ! I > - Boathouse/Boatlift 4 i — _ Beach Bulldozing /� 1 �r �� Other I �t+�,'��3� _ I � `Rj 71--"- �`tri:f"S Shoreline Length ' 2'6-e, I, .-4`)1 - I I - Moratorium: n/a yes :u - Photos: yes no I g-n1 ig o-J Sl lafC_ Waiver Attached: yes no --_ O✓dL LW- 1 A building permit may be required by: -4 f6:'"T-/o > See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) • Notes/Special Conditions 00,1'14-4tc7 *PIA-rht/4l 70,i C.p617/-i-io741i /9Pl240v/- 6---z, -il/e-0, iEL4-1 S Pi vex Agent or Applicant Printed Name Perm' Officer's Printed Name r Signature "Please read compliance statement on back of permit** Signa e pa c e- A9t200 _ /a-7 c __744ti usz -v- 3 276z. Zo' 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: Meuse 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 (252-946-648 I) 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 252-946-6481 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 0 LAMA / DREDGE & FILL No. 74131 GENERAL PERMIT Previous permit# A r)C- - D >Z _'New CModification ❑Complete Reissue ''Partial Reissue Date previous permit issued },1 1k 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 I Z D(---) . .Rules attached. Applicant Name ID k4 /2D/4. Project Location: County l�j„T._/)" �3 Address / Of c' 05?Z.4 / Street Address/State Road/Lot#(s) 1 v ' .5; 6 ,, City , /-,1/' /(r-ro i' State -) ( ZIP "7"-7- <71 Phone#(-2-< 2)y/(o`$ - E,V c- j E-Mail -= -1'. t 1 c1 P Subdivision i- cv i, •, .> '. f, -,_/-7 Q Authorized Agent NI /A City ;,..,//:- .J.4i-r-)I�-rz ZIP --).,15 .1 Affected ❑Cw ❑EW 'I PTA ❑ES ❑PTS Phone# ( ) River Basin% -1'1i,+-.t. , i v 'AEC s : ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body_ 2%'U O ❑ PWS: y ,� ' ' na an /unkn) ORW: yes / no PNA yes / noo) Closest Maj.Wtr. Body J/F1r'11-1 e> "2'' ter—"-YL Type of Project/Activity /-2. -). /2- ��J/77i.-/t./ P. G-t.) < , is-,.... (Scale: ) - ) Pier(dock)length y I Fixed Platform(s) i Floating Platform(s)\,,/2 7'JZ. Lt- V—Z.2Cy, G12- — , Al Finger pier(s) 1 • �/ Groin length i i , number I i /"3TIe-- ?7,1t Bulkhead/Riprap length -- I , avg distance offshore ! ' ���� �> D .� eV 1,-+7 r l jr, I . max distance offshore i ex k�'''-i'7 Basin,channel ^��', I J>1"'r4' S cubic yards — — ............ Boat ramp Boathouse/Boatlift_ — -1, I I i 1� Beach Bulldozing /V V' '' ... Other �,..1 4)-"tn }., . rill1 , , Shoreline Lengthf Z C-6 , ,.l‘ i 2. - +..-.„, SAV: not sur----e) yes no ^_ —__----- _..._.� + I. Moratorium: n/a yes rfo_-D I ,444E --� I. �U __ Photos: yes - no 1�?r 11 Pt> . Waiver Attached: yes no Q✓+ol A A building permit may be required by: 3e -4'mac%` 7T t'rO • . .C1,See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) Notes/Special Conditions 7-"' i' 't+c�r,"__ (4A 11ay/-i__ 62 /V rt--0 /S 'e..1-GV el vcv► Agent or Applicant Printed Name Permit Officer's Printed Name glik Signature ***lease read compliance statement on back of permit** Siigg1nat_a e 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(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: 252-247-3 3 30 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 . c, ,2;!:14 , 0v. „ 6:03FM 'rlE ;ICI, CO -- No 3523 1/1 ...........: ....„....„,,,...............1 P.c. •T" suoe 1 . 15. P 4.1 43'Ell,04 so . , ''•-•-------...''\,,,,,, .......... ---•--- -- > . #4. IS)L' • -, . c.,... i- , r A•# ,.. ".44,,,. A' . `4•4 ' 1 • tiN e-••• fr) 4, NC/ ( let , It. - vrN....,'" • . . , ,.. . „.. . •••,......„ - 1 4,- , 4 4 490" 1 wETLANc; : (•,-, - • * ,9 , i t 46 • • • . ---- 1 1764 CP ES ..,. P C, "C', Si,tiE 175 I t 1 6 I • IM IMO MANE ' w qt. - '....... HOUK . gi 4' .. • PK/1,•WE ,• c'11') p p--/1 t'‘ I N.,. • a 1 ' . \ .00 .# z . 0 ...,'"?..'''''. 1: • 1611\ A .1 I di s.1..; SA1-,, •' 4 / '.. 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'NO TES : "k 4-0,-.,2-,..,•;10wr-wfwit44,7htt, ,..,..,„,- 011SX Al.,...iik A DPECIAL. FLOOD HAZARD 4 '1 •, 4 -", .4.'-'-",,,1-— -, --,'",11 .000* Ioi, •-,, -,A, _,... ,' 4-',1='`== "' ' ,Ai)faAs k,DeTeRmiNED wr H3uomA I-, - k -77.•-4, ,1,- '--•.,t),„, -e-..: k-„; ., ..--- -•,--.'rt"--k-.4:-,-,--,- .::44 .4.A ' 1)013 is -tv4.„,,-,;;;• ,z,,--,,,-,-4.,-, $,•itiz;tti .;-r,------:4 ti.'-'77,'''' *-,..217,1' '.I..":"r .` , ,,,,„e".,P°611441Mn '.1`.. 7**'"•••4" 7:' 4' -.,"` '•'V c`4'..*/ 41:,,,''' .74/---4ef.''—17.L.„„-'1.4A444....--A, ' °'- , ,,, , 1 `..L.Atir,•, ".''- * ** .. - 1 7,„ '„,-7.**.e----',.. , ,• AS" ; oi : $' ' 1-_,,-- . ,- %,2 - ',,"-7.1-, - ., • '''' , , ;.`;:""*= V-/.•:- ' . ''': UMW. PIPE'S'AT -AU: LOT COMERS. rtrObr'-,' t. ;le. * itr ) ..7 ,,'4,, ",,.... ,-1,-,,I,„,,,v.3-,-;.,,,;;,, --.. -..,,, ..-7?,.. ,,J 4 • . *'' - .- .,.-c z ---`,., '.'c',,-4 „2:,;,,,,,z4.„....-.....-..,....--t- ' , - . • .,J. ,,,,,,. , • , .. * ?rt., "7:..:' ':-',;.-,,,--:-....; -- •., --. '-'--. ..5. EAsEmErfrs AREeREsERvED AS FOLLOW&' . - ' - - ....p. ,,,..-i .4.to.....-,,-..., -.--400- - 'F'.; ,--,' - • , i tilt T LINES * 7.5' 1 - „--., • - ,--4,-, ,,,.,,,-,4,-.::;.11,14,1,..-.--v-a,•!a„:„..;,;,-- ,..,‘„,, _ ' ' -''' - •,- 4 141',.' Y.,:'''W '{:,,-;k '71-', '7: '' '* "Wit n"A A. t �. CEA6T RIPARIAN P t�RRt'^f 4tiER, TAX N ;_ i mere eerts a q,,. '.r rl'that I men*to 7,, _ �e" .tl�-- fiarrsiiaceret to 2 ._ awns} PreflertY toted at ,,, tNamc�of Propethl __.—, on *`/- ewtx 4 (A Toss,,-�:.t Stook, ct:ate.) r ,NC (CitylTown anchor c,Ounty.) The er) _3nt has —----, : roomier) O me as shown below. the development proposed at tr'e at 8 --- t have 110 eblection to this proposal I have obieczaonS to this proposal DESCRIPTION A►ND/OR DRAWING OF- PROPOSED DEVELOP 'I N'f findiviciiini posing eveto a u�st fist in eiesaniPiiQ behove or'mob sited Rom►"�Q) rto *a, f. _'r t a Ski c-',csG.. ti # LYc,"s .p.1.`", Nit'' e?'`'' (f`C.,e—5 : ,W.7 40)44' tdri4.;I'' Z,t4 rf I WAIVE SECTION t underStancl that a pier" dock mooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me- tit you wish to waive the setback, you must initial the appropriate blank be'ow ) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requiernent. (Property Owner�Information) (Adjacent Property Owner tnionrctattion) , . _.._ inaitor ; Signature � .A2d--4-e-O--W-4-Aa-- --m Print.. ype ial.... zi.___, Print or Type Nome , .16, Halm • .r` - . Marl d . r."` _ �. Ai. '; ,,.e . i at' r, '�. `4' 01 f U c. ,...,,,,dvizto.“1,,ggiA,;"it 4$ ,,,,t'''4,-3.,„ .-:-.... ,i, _.- / - 'Apikos .' •-.Dis ' ' y` c. lo^: - ' Y!` bO ,gyp$ 3 Y I' P" r Tereph4 M/Fi' �' .�.�`ice 2 4 t i 3' ,p -anti.. __.+.ro. trA {q, F r: o 'alb Dam 4 _ . _:_,..: . , ._„4,...,1 , 4.z...... „,....t, , ,, ,„.,.., ,..,,,,: ,, ,,, : , , ir*,, :„,,,, .... ,., .c, .,,,,:. ..,, . . ,,, 4'"'„,.4 .•„ -,, , y ,, .,,-,,,. „.,. . ,.1c,.,..,..„.„. ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to L .4 I 4(1 r{_ littr%!-"; 4 's (Name of Property Owner) property located at 0 6- Os,�� - / (Address, Lot, Block, l pad. etc.) oroon ,., - in ea ,.(c.,-- - N.C. (Waterbody) (City/Town and/or Ct�unty) The appl. ant has described to me, as shown below, the development proposed at the above locatio . I have no objection to this proposal. I have objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual p posing ve/opgne t jnust fill in descri do below or attach a site drawing) _7vsy4 As r. ., p t g dov b It �i'+ ✓e �-� (FA.�' .•,5 „re_ J r s/L t da c G(rS7r we 1-/� _ cr1'1 5 7 t.k I`�U 1f I , �- _ nr f _....... _ _._.. .. 47:/7,40 a ... fro A.144 / WAIVER SECTION I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to aive the setback, you must initial the appropriate blank below.) I do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. (Property Owner Information) (A ' ent ope ner Information) Signature Si nature v L:v,' ,,21) PLAN -i _: C I � Print or Type Name 'nt or Type Narrte Loa G ':)"y 14 ,1 l'o`. C ree vle Lq..,t .-. Mailing dre Mailing Address fit/ ` Al C. 2 l.fe t v� (A.. N— 21.p sr. Crty/State/Z`b r City/State/Zr ,..7r. eic(i -64<0,3 aS .--1 (?-OCot'S" Telephone Number Telephone Number ......_.............. Date Date (Revised 6/18/2012) Pamlico Plantation Rules and Regulations Manual Procedure Number: R&R 30.1.4 Title: Architectural Modification Form Date of Issue: 16 January 2013 PPPOA Architectural Committee 150 Clubhouse Circle Washington, NC 27889 This form is used when you wish to make changes or additions on occupied lots and existing structures. This includes structural changes, exterior repainting,tree removal etc. Please refer to the Covenants for specific restrictions. , J G Owners:�s, �- c..X144(.. /,��, Lot Number: 0/ Address:dG 6 0-5a cr v / Telephone:��o- L/C d'f(i 3 J / We request the following: .7.;s>�r cc f�o�. a � c/a4 fj`� rytC O -� /o4z T . - Glipf Attach any applicable documents to support your request(but not limited to) sketches, site plans, color chips, etc. For tree moval requests, mark each tree or group of trees to be removed with a red band. O/ ,ti Owner's Signature Date Architectural Committee Action: Approved: Disapproved: Date: Distribution: Owner Architectural Committee Office Page_1_of_1_ t \ Spivey, Kelly From: Waida, Ed <Ed.Waida@westpharma.com> Sent: Wednesday, July 22, 2020 4:26 PM To: Spivey, Kelly Subject: [External] RE: [CAUTION: EXTERNAL]CAMA Forms Attachments: IMG_1208.jpg CAUTION: Hi Kelly We got the POA approval for the Floating Jet Ski Docks for 106 Osprey Bay, Washington, NC. (Pamlico Plantation). The Floating docks are on order and should be delivered by the end of the month—we hope. Please let us know what else we need to do,to be approved. Kind Regards Ed Waida Sr. QA Project Specialist West Pharmaceutical Services, Inc. P: +1 252-522-8975 I M: +1 252-468-6403 1028 Enterprise Blvd. I Kinston, NC 28504 I United States Ed.Waida(a�westpharma.com www.westpharma.com IJestBy your side for a healthier world" From:Spivey, Kelly<kelly.spivey@ncdenr.gov> Sent:Thursday, May 28, 2020 9:57 AM To:Waida, Ed <Ed.Waida@westpharma.com> Subject: [CAUTION: EXTERNAL]CAMA Forms CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Kelly Spivey District Manager, Division of Coastal Management North Carolina Department of Environmental Quality 252 946-6481 office 252 948 3851 direct office kelly.spiveyncdenr.gov 1 P aml1CO plantation Property Owners Association 150 Clubhouse Circle, Washington,Telephone: 252-946-2390 July 10,2020 Ed & Debbie Waida 106 Osprey Bay Washington, NC 27889 Dear Mr. & Mrs. Waida, We have approved your project of installing a floating jet ski dock conditionally. That condition being your receipt of approval from CAMA for same. Please forward a copy of that approval to the committee in care of the PPOA office before you begin construction. Regards, Kassie Adams Administrator Pamlico Plantation POA .rs NC Division of Coastal Mgt. Habitat Impact Computer • Applicant: ✓ �79 /DA- Date: 3 eq—e_or Li 5 r_ •2 u-z!7 General Permit#: —7 Lt ' 3 ' Describe below the HABITAT disturbances for the application. All values should match he game,and units of measurement found in your Habitat code sheet. TOTAL Sq. Ft. j FINAL Sq. Ft. i TOTAL Feet I FINAL Feet (Applied for. 1 (Anticipatedf lal (Applied for. ("Anticipated final DISTURB TYPE Disturbance total disturbance. Disturbance i disturbance. Habitat Name Choose One j ncludes any Excludes 3rY total includes Excludes any anticipated restoration any anticipated restoration and/or restoration or and/or tot p restoration or temp impact temp impacts) impact amount) temp impacts) amount) OP4-7,/ ; L Dredge❑ Fill❑ Both ❑ Other /9 — I I Dredge❑ Fill❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ i Dredge❑ Fill❑ Bath ❑ Other ❑ I ! Dredge❑ Fill': Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ i J ' Dredge iJ Fill❑ Both ❑ Other ❑ I i I I Dredge❑ Filf❑ Both ❑ Other ❑ ' I f Dredge❑ Fill❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ I I Dredge❑ Fill❑ Both ❑ Other ❑ Dredge❑ Fill.❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ Dredge❑ Fill❑ Both ❑ Other ❑ i