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HomeMy WebLinkAbout77220_Chris Furlough_20200826 /v,x).. °04 I�•CAMA/ ❑DREDGE & FILL J D NU 77220 A li) C D GENERAL PERMIT Previous permit# /V/� Yam. L New ❑Modification DComplete Reissue DPartial Reissue Date previous permit issued /0- As authorized by the State of North Carolina,Department of Environmental Quality /�o D 7�''Z� and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC f4 Rull/es--attached. Applicant Name Aj7 5 DG(,q Project Location: County_^- Address �9.. ` . Per;r<I _ /ti�- . I C7•?a7t alb Street Address/State Road/Lot#(s) 29 A-` "' City lit/0.9 _State fr-i ZIP -7-7S89 400,,.-' -[ls,< <Go 4- $) Phone#(Z�,f,3 5594/ E-Mail__ Subdivision 1'fr\•—ccyno),Q 5 1"t5 Authorized Agent C--/—'L-- // __ — City LL)& r' '^- ZIP i-7` '9 Affected ❑LW SKEW %PTA KES 1RPTS Phone# (2-5 L)9Y3 S592 River Basin �'e- . AEC(s): OEA ❑HHF ❑lH ❑UBA ❑N/A Adj.Wtr. Body m 4 pt V,-' nat ai /unkn) ❑PWS: - ORW: yes PNA yes Closest Maj.Wtr.Body ? f' L a--.`/`''. nType of Projec Activity ai'l�C `t �PoSeS /06 p' c'tE l341 k(.c t, 2/K,k4-'"`"4--r°1 s`J ycrs 4--`�") ?1/‹. 160tx[m' ?r- '/ /10 )c25 PIa-14+-- r!, )/6X iecir ped yc34.3.- 8,Y/il Scale: 1! 36 ) Pier(dock)length 10e2.___— - .P"/L Fixed Platform(s)/(P�+.25 / �C,Lhi r R / 1 + - j._r ' _i_ _ r i . I uZS : Floating Platform(s) , I-- } i , Finger pier(s) � � i L_ t L Groin length 1 .. j -r-, . - - �- �h ,� 1 number i ! p of i.- ' '1 � t l - { i o `G` I ''col Bulkhe Riprap length �� L.___ _� j7jk�3l'/r p' \!o o 4 X s avg distance offshore 2 / 'c' *I a� , max distance offshore Z ' - t- r e a i�x7�� +7!., ,- Basin,channel I i f rnP4? /r/ ' i. . - cubic yards ,. Boat rampj 1 -i' 1- - i ,�1�� a- Boathouse/Boatlift i • j-- trf'"`r ' ' ! t I I i i go e •I I T.B� - C,'bf✓� l i - . Beach Bulldozing_—._. i ' i i • J- - ` Other !--4-1"-I----4- I- ( j C, 1--:- :.............. - � ..._ i f �_...i..._.--. p l.:v a-C 4 .._.ICyc26 (1- ,r„ l� aiwc P� S cQ _. -� i Shoreline Length 7 __ __{ L /s 1 i- i SAV 401n iri yes no �3c..f I i- too. - - i i ' • i- �U I . ' { Moratorium: n/a yes ® . T-�,,f 1 E? i . p , Photos: yes a i ; .., Waiver Attached: ! !p , A building permit may be required ed by: t . 96 See note on back regarding River Basin rui . (Note Local Planning Jurisdiction) / pp Notes/Special Conditions /.)C/517v, g/c. //a out.1.6 (fie tinreV-el / './/V"^) 2-& -/. Z 514°z rto!..) "FN f jf d Zl H,o. /w"l•C ,n cacls�a 1 '' :SaNr�cAS.,nry +t- - L3e o ctr,-0 eAce. fto-• t,'�r,2s' 617400.(( per s-l•/ naitie) l ar, /G ,,,,,0 elk' /1- / /a/v--- t r plicant Printed Narrfq Permit Offic: s Pr' -d N i — es)..a4 Allill.2111b. Aar natur **Please read compliance statement on ck of permit Si: �SlR'� Si4 ..)c 24, .2.- ?-0 Application Fee(s) Check# Issuing Date Expiration Date! 1 0 CAMA/ II DREDGE & FILL N° 77220 A O C D GENERAL PERMIT Previous permit# /U/t �� 7New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued /1//-- As authorized by the State of North Carolina, Department of Environmental Quality �� //0 O 7��I Z6fl and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC . Rules attached. Applicant Name efiri 5 -/+1O41 A Project Location: County Address 0,219 /4-..gI- PSI I f tie___—}?, c7, 13ax3/8 Street Address/State Road/Lot#(s) ,,9 At City tA/as h, State /J C-- ZIP Z7889 41.4 -) .n Y c L'D -IL $� Phone#( )" ,K3 55-9 y E-Mail Subdivision ON4.9 ro),ac 5 {fit 5 /Authorized Agent fib`• �41i_^-- // City wash" --- ZIP -2-7f Affected ❑CW XEW %PTA KES •OPTS Phone# (Z S5 2-) 9Y3 G J4" 7 River Basin 'e-P, E OEA ❑HHF E IH ❑UBA ❑N/A AEC(s): Adj.Wtr. Body'70.7Yr,4 Ri\/'yi 67)rnan /unkn) ❑ PWS: ORW: yes PNA yes Closest Maj.Wtr. Body �+-l� 2.v� Type"/of Projjec Activity �/.'i C C..-4 l p c c /e6 4L Od[ 3.41kk oe 2/h.Jt� `-"✓ma0 e c `. c_ s 4-` n l kt.+� moot x(a' .Rr '/ I o>25 1Pla44-f--' td/ g'X 2.e cfn fe,4„)'q' ._ /Fifty 1 Scale: i i 3 C) ) Pier(dock)length /0e / B / "L Fixed Platform(s)//Py,25 I -�. —'— ` A 1 V(-- Floating Platform(s) j Finger pier(s) ; { ' �` 0 "eG/ la 1(2S Groin length . I T x wh number �lDp��y - l_ 1... 1 l _ Bulkhead/Riprap length / 11:4 O ' i 4I avg distance offshore Z , , i max distance offshore Z / i i t �A G Xlcd /t{• /�• Basin,channel I ��at� /' cubic yards I I r : j Boat ramp ; I 1 ,'454-i •l i , ' I ' I Boathouse/Boatlift f 1.-- ` Y- Beach Bulldozing 1 I B I L Other ( , ; �} • Ink_ ! ! ! Shoreline Length f / 7 f 4stc SAV: ,111111' yes no I ' t 1 �_ i A . ___..4._. Moratorium: n/a yes 6c2 4 I Pihl, i r 4., j 1 , 1k'0ee_ Photos: yes dr) I 1 -- — } ...._ — ... :v -- p- --- ie Waiver Attached: ; I i I t i 1 , I ,to 2 V A building permit may be required by: Oc a4 t,4 '+- . 7 See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) pp / / Notes/Special Conditions 4X/S icp, pGt/L /,F-t ieb,5� be- feoPe 1 -4 4//v 41-) 4. 2%,i1L/, /-�Z 5140%. r+'1�C) <A41 Z' i„,a,J.c.r„).,,,,--A , ei. .2",c1sk' alp"� Sa �cA'(.?"1 w r. t 'e„". -' — 9a3e- o d<;40 �� r r- exc l ,Jx2S' &740 0-•(--t2— peC- S41ku / ,',a- _) , Xa4--- Agent or Applicant Printed Name PermitOffic: s Pr'• -d N — Signature **Please read compliance statement on back of permit S , ' Al�Dv �` /37,0 26 ,2—cpzd .324, le 20 _ Application Fee(s) Check# Issuing ate 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 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 (252-946-648 I) or the Wilmington Regional Office(9 I 0-796-72 15)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 CAMA / DREDGE & FILL N° /7220 A B-' C D GENERAL PERMIT Previous permit# ' >� ...New 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 15A NCAC < v _ Q Rules attached. Applicant Name on :� -f-�<t/C ca)/I Project Location: County 7*i- Lr �-- Address -,.=G' 1 // ;-�, ram`,,,1 -. , , r�� Street Address/State Road/Lot#(s) 22a9 ' -, City .,0-, ii;, .-,1, State tic ZIP '2--7Js/,, I .-+ i , , , Phone#( 2 ) '/%? S i// E-Mail Subdivision i l N,-i}( '. -c Authorized Agent /(1 --/-7-1`(--(, ''-'--- City l.Uc,51 ,+._ ZIP_:- J-7S ❑CW ;STEW %PTA ')SES TS Phone# (/ 2) 9%377>79// River Basin J`e- 2,,, Affected ❑OEA ❑HHF ❑IH ❑UBA ❑WA i / - AEC(s): Adj.Wtr. Body /---1i t-- t ' 1 c1 / t - Y (nat 7man /unkn) ❑ PWS: Closest Maj.Wtr. Body-^ ,, I' (- c l' '` ` ' ORW: yes / no PNA yes / no) Type of Project/Activity 1-1-0- ,06/ T� k ;, 2 t.}0,4*-,.va_t -( ol C_y(; 'L;,� u ` / l ^r}[ [ / 8 y ; A fie)43, 1.4, /iil'/i 1 (Scale: /' 3 a ) Pier(dock)length Cl i7 ./ //trZ- Fixed Platforms)/�',1,2-c-: I -�- R,-,‘ :A• t-G 1Z 'v e r 1 l I Floating Platform(s) i , 1 I Finger pier(s) �..__�.. Lr Groin length } * pi,,,4 Fd4 t number #;Df?o__G .._.. .._ i. s./.... A Bulkhead/Riprap length /n b sH_ 1.—_ I I . y/"�r 4 4 - , ___.fix ('OtAee G�_ ,ye bei I avg distance offshore - / 1 1 max distance offshore l ( • o Basin,channel / I j / 0 zz.F` Gk o' cubic yards i Y -- _ , Boat ramp f t .,,..I r t i al top --._ i Boathouse/Boatlift — • - — / Beach Bulldozing —; -j + Other 1 I i I t I Q, ,J X i c (r 1 t t i I _ h Shoreline Length i 7 l 6�'s l y / I SAV: not sure yes no &I 1, 1&,i Ne.-i/1.. — ._... ' 1 ' I Moratorium: n/a yes ; ( !, -.._�__.�, . .. ...I i _._ -._ r. t L Photos: yes i — 1 ? doh if`t.3 ' � I Waiver Attached: se * j 1 r A building permit may be required by: � ��_ (. 17 See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) Notes/Special Conditions kir 4) 9 7Ct'c /,C/ n lr �1 )e fer '" */ 4 ,//:- 77 / ,,{/, 7-I--(/ ' /k/\'aei Zt wr..J-t,'tc,• i )12u I 6t(i ',,�, • ,..., ` -,,„,, ,(;Qt„,t.G,.-�- - r, Ci, . �t 2xcnnc 1G 'x2`�r (`1oo-11 ,vt-,— <-4rtct->Lu—rre. ,),,y 1 1. 4)1 r( /C{t— Agent or Applicant Printed Name PermitOfficer s Pr' d N e Signature **Please read compliance statement on back of permit** Si ,/-d. (At e_ lG.('n r`_ /7-7/n 11n, 26 l 1 , 7 o c 2 . 2 r 20 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 0-796-7215)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 _ CAMA / DREDGE & FILL No 77220 A B C D GENERAL PERMIT ' ! } 4 Previous permit# )1 .-'-- . New 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 Rules attached. Applicant Name ,, , -i-- �' / / Project Location: County - Address • ,- - Street Address/State Road/Lot#(s) City State ZIP Phone# ( ) E-Mail - Subdivision Authorized Agent - City ZIP Affected ❑CW ❑EW N PTA f•J ES ElPTS Phone # ( ) River Basin • - AEC(s): 0 OEA 0 HHF 0 IH ❑UBA ❑N/A Adj.Wtr. Body (nat /man /unkn) 0 PWS: ORW: yes / no PNA yes / no Closest Maj.Wtr. Body Type of Project/Activity / (Scale: )• - ) Pier(dock)length / if ' Fixed Platform(s) _ I ` _,,,�--- \T.�.\, !' i c: k `r 1 1 1 n 1 Floating Platform(s) j Finger pier(s) i. . _.. _ -- '- Groin length -- —^.. 0,4•it ‘ number i} ,`-' -r ' -i ; 1( ' �t* r i� ; -� Bulkhead/Riprap length , r L.. ``.@ 4t i l ( _. l avg distance offshore I ` {i 1 1 I l max distance offshore ? A Basin,channel I I, e/ 1( X l r,�. ' 1 i cubic yards j } 1 - i 1 . - . . i j 1 I Boat ramp i 1 l l fw. 4 ,:-/ o ' '4 I 1 i i Boathouse/Boatlift — t. r_i J �' :ter — • _ }_ . ..._._..._._ 11 (IT ...._. 7 1 I I Beach Bulldozing - — — - j - l 1 ; — I- I Other l l l lI t 1_ 't t / . Shoreline Lengthf i / j SAV: not sure yes no 1 t_.111 /' ikl,, .,`! . f — `j �— _ __�_. �..�. 1 Moratorium: n/a yes no I ti 1 11-A . -- I I. -f : j" i i — — �r 1} c f.,-. Photos: yes no i _, ' s Waiver Attached: yes no I , A building permit may be required by: n See note on back regarding River Basin rules. ( Note Local Planning Jurisdiction) Notes/Special Conditions Agent or Applicant Printed Name PermitOfficer's Printed Nan,t r• Signature **Please read compliance statement on back of permit** Signature _ 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/ 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 Authorized Agent Consent Agreement c c l0 v ,herby authorize Tobin Jay Tcttorton of (Property Owner(e)) TJ'e Marine Construction,LLC to act on my behalf in obtaining CAMA permits for the location Iisted below. PROPERTY ADDRESS: 2-0 Z. '9 Lo4- 8 rna -no ::..\n sec PROPERTY OWNER'S MAILING ADDRESS; S �'O 'i;tic SW) t .s1rV; s44:.n. v� c 2-7g s Phone No. Z- 2_ o " s -c • PROPERTY OWNER'S SIGNATURE: AUTHORIZED AGENT SIGNATURE: TOBIN TETT + TON ,JDATE: 8--« 20 2v W/Authorized Agent Consent Agree. I hereby certify that I own property adjacent to 31)C-N\c- A- u, cv_cAo Jk� 'L ; property located at (Name of Prop y Owner) 11 __ �� 5 y s o. � `�c4� 1.. Lam.. f�l C' 77raf filasrmi►aon l c� to r-(�ddreIn t of t3to Road, etc.) Vx. (WctetbodY) (City own and/or County) N.C. Tho ep !iccnt hoc described to me, as shown below, the development proposed at the above locatl . . 14:..z,,::: I have no objection to this proposal. I have objections to this proposal. 1 D CCRIPTJOH AND/OR DRAWING OP PROPOSED DEVELOPfViENT (individual propocing development mutt fill In description below or attach a cite drawing) t 1 I• - i o L1 k - o 1kV e..a, (. acsx _ ygar_=C i e�?FJ Proi�nt` I understand that a pier, dock, mooring pl!Inge, boat ramp, breakwater, boathouse, I!ft, or groin -». mum be cot beck a minimum dfatance of 15'from my area of riparian access unless waived by ''`l' me. (lf ou wish to waive the setback, you mutt Inftlp_l the appropriate blank below.) I do wish to waive the 15'cetback requiromonl. I du not with to waive the 15' cetback requirement. (P Owner Information) Ad ace r o ( 1 p wnor Information) sJtrl(�t1lYC Sir tl' �' � c' tv. JPilAr fps Name Plnf or Typ N�v�, tip- - `fir.YY� s t Melling Ad ro„a a / d r©ss City/Slate/Zip .1-5L943 ssq !_._GOf 2 errbw Ma;1.c.M CItyitataQyc:i y y 5 )--3/ r Teloph ne Nr mbcr/©moll address `�� -5 t v Z o To/ophon Number/email address Data R� A� h 1 Date' i f-} aa S SS6-ip1,1 -b ,b Imp t wrirl Tv*!1 POUirw o ,Ot t,+pgp1 r rgrocv ryvu,o,1 Qw,i,Y cips,`da;0,1 Pu i oet.7 ',w1,ef1.tA c SLk,125 v�•,orv,.,..4s �.a c. SZ" 1i r•S C2,27;€312, }t1iQ J t:aApyCuwion a a u ,_, ._..__. aera ytc3 NV ea,IO Mid u C01) •ant 'iS »77 .1.4y5 Ti (uon3 LUMP;.ouMO AtJcdo4d iurpa,• RV) (u0n7wJ0}1J1 J.Air. hi) 7uowoJlnbw>lxglus ,g 1 a43 OA4YM of tl':1M lou op i tuotuoJInbos r egos•St eta 0Aft1M of tj,»,cp 1 1,('Mojaq Kuniq oiol,da dda n or('7i'.t 4 rrniuMiTiff nor( at l 0A{7M ol 4Q1,w noA il) 'ouu Aq PaAioM ti.O;tm cs032U utryJCdlt;o uvJU/.u7 um; ,gt to oournelp wm.qu+w a>nrig 1al oq t:nw u{0J0 is 'flit 'CO1104TV04 WonWoosq •dutu4 it'oq '¢Sutii4 CN4ocsw 'spop 1104 0 Iota1 pt:3;04opun 1 ti WOILl.iti tidAtYM t _ ___... _._w__ ., off �.-- t i Cn/�A 4 J ���� 4/4Q, I. 2x�N (cluJMo1p oJ/r w spono Jo"AoJog u01)d113.sp u,11,1 J n:u Julwdop o[lu/ cdojc'/7n,01A/Pu11 1N36'Jd013A3Q 03COdOtid dO ONMwfu0 8OIONY HOLLdttiOCT.0 le odCud£4:01 su rpafgo OAC4 1 wsodasd spl ol uc tao qo Cu eAey 1 X QA0gJ 00 to posodold ufu,do oAo- o •Ho z • VOI1Ml 1 i ? 1J1 hC untio4s �.. 73,3J � paqu Lt7p tJt1 W?�;}dCJ Qt(„ (A3uno0 io/put: unto 413) (k'ct;,gut V _._ ('0; p;Jot!'1 ot£1 `to, 'c:i , ' "C*% "ua Jiq-NV aPt) s »,s+ .mow sw'Q407 3e po;uxt At.icdord (sou go.aoda o otuet,;) t• aA s v \ p -Lot of tuoou pe k,adoid tpxo i teto t:= ti a a-- .. 4C DiNisjon of Caastai Mgt. ;-4aOita. Impact Oornp4..iter Si e Applicant: CG`r;5 .-z✓ date: 5/Z6/ Li-2 3enerai Permit# 7 7 .Z 20 ?scr e celcw:he -+.3,317a.7 iistLrbarces'or:he aeoiicaticn. All values snouid matco he lame, and units of measurement found in your Habitat rode sheet TOTAL 3q. Ft FINAL Sq. :e. -OTAL Feet FINAL Feet :.apoiied'cr. a.nticioatednal :;apoiied ror ,,Anticidated inai DISTURB TYRE Disturbance total iisturoar . Oisturrnce iisturbance. Habitat Marne Choose Ore ncludes any Excludes Jr, :ctai rcludes Excludes any anticipated -estcra w ?ny anticipated restoration andior restoration r andicr zin •estoraticn :erne rnoact :emc Impacts: react am cunt; :emp'mcacts 3mcunt //G2 5A kv__ recce =ill`s Both Other = (p G • 'redge= =ll' Bath = Other /5 :) ! 5 v • i t 2recge- =711_ Both ther Dredge= =ill_ Both Other :recce =ill _ Both. Other O recge _, -1 Both _ Other Dredge - .'II Both Other _ Orer_ge _ ='ii = 3cttr _ Other O r acce_ =!i= Both _ Other _ Ore_dge_ =il _ Both Other Dredge_ '.II _ Born T., Other _ _, Both _ Other ,.cecge_ -'il_ Born. _ Other _