19950751 Ver 1_COMPLETE FILE_19950110

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Coastal Management
James B. Hunt, Jr„ Governor
Jonathan B. Howes, Secretary
Roger N, Schecter, Director
July 19, 1995
T5_751
1••
EHNFR
RECEIVED
JUL 2 1 1995 C,
ENVIRONMENTAL SCIENCE1,
('D•,,-U
WASHINGTON OFFICE
OFFICE
JUL 2 0 1995
A F.
bMORANDUM
?v
TO: Mr. A. Preston Howard, Director
Division of Environmental Management
FROM: John R. Parker, Jr.
Major Permits Processing Coordinator
SUBJECT: LAMA/DREDGE & FILL Permit Application Review
Applicant: Richard Parr
Project Location: Lot 21, Sec. A21, Holiday Island, Southward Lane, Perquimans County,
Albemarle Sound
Proposed Project: Enclose around the base of an existing pier 48.5' x 10.51, extending
10.5' into a man made canal approximately 65' wide.
Please indicate below your agency's position or viewpoint on the proposed project and
return this form by August 9, 1995. If you have any questions regarding the proposed
project, please contact Frank A. Jennings at [phone]. When appropriate, in-
depth comments with supporting data is requested.
REPLY v This agency has no objection to the project as proposed.
This agency has no comment on the proposed project.
This agency approves of the project only if the recommended changes
are incorporated. See attached.
This agency objects
attached comments.
Signed I
to the project for reasons described in the
Date K11 S ?C?,-
1367 U.S. 17 South, Eltrabeth City, North Carolina 27909 Telephone [phone] FAX [phone]
An Equal Opportunlty Afflrmative Action Employer 50% recycled/ 10% post-consumer paper
DIVISION OF COASTAL MANAGEMENT
FIELD INVESTIGATION REPORT
1. APPLICANT'S NAME: Richard Parr
2. LOCATION OF PROJECT SITE: Perquimans County, Holiday Island, Lot 21, Sec. A21, on
Southward Lane, man-made canal on Albemarle Sound
Photo Index - 1989: 1-16, 4 (013) 1984: 114-792
State Plane Coordinates - X: 2771800 Y: 85375
3. INVESTIGATION TYPE: CAMA
4. INVESTIGATIVE PROCEDURE: Dates of Site Visit - 07/12/95
Was Applicant Present - Yes
5. PROCESSING PROCEDURE: Application Received - June 12, 1995
Office - Elizabeth City
6. SITE DESCRIPTION:
(A) Local Land Use Plan - Perquimans County
Land Classification From LUP - Conservation
(B) AEC(s) Involved: PT, EW, ES
(C) Water Dependent: Yes
(D) Intended Use: Private/Residential
(E) Wastewater Treatment: Existing - Septic system
Planned - Same (no change)
(F) Type of Structures: Existing - House, sited and pier
Planned - Enclose around base of pier only
(G) Estimated Annual Rate of Erosion: Less than 1'
Source - Applicant
7. HABITAT DESCRIPTION: [AREA]
DREDGED FILLED
OTHER
(A) Vegetated Wetlands
(B) Non-Vegetated Wetlands
(C) Other
Public Trust/Estuarine Waters
Captured
509.25 square feet
(D) Total Area Disturbed: 509.25 square feet
(E) Primary Nursery Area: No
(F) Water Classification: SB Open: No
8. PROJECT SUMMARY: The applicant proposes to enclose around the base of an existing pier 48.5'
x 10.5', extending 10.5' into a man-made canal approximately 65' wide.
Richard H. Parr
Bio Report
Page Two
Site Description
The applicant owns a lot approximately .30 acres on a 65 ' wide man-made canal in the
Holiday Island Subdivision, Perquimans County. The lot is located in a neighborhood of
developed and undeveloped lots of similar size. The developed lots have both seasonal and year
round residences. The canal empties into the Albemarle Sound. Utilities include county water.
Sewage is handled by a septic tank and drainfield.
The shoreline elevation is approximately 6 inches above the normal water level (NWL)
of the canal. An area of approximately 750 square feet may be "404" wetlands. The applicant
states that the USACOE has been on site "years ago" but does not remember exact location of
"404" delineation. The lot rises to approximately 4 feet above NWL along Soundward Lane.
The soils on the lot have a silt loam texture. Vegetation on the lot consists of yard
grasses and loblolly pine (Pinus taeda). The waters of the canal are classified by NC DEM as
SB and are part of CAMA's Estuarine System Area of Environmental Concern.
Man-made features on the applicant's lot consist of a 30' x 36' private residence and a
101/2' x 481/2' wooden dock with a raised wooden walkway leading from the yard to the dock.
A CAMA exemption was written, by this office, May 29, 1992 for the dock and walkway.
The applicant proposes to enclose his dock underneath the outside edge by nailing boards
placed vertically from the dock underside to below the NWL. Much as mobile homeowners
place skirting around the foundations of their homes for aesthetic purposes, the applicant wishes
to accomplish the same. This skirting will not touch the bottom according to the applicant.
Anticipated Impacts
Construction of the proposed skirting will cause temporary water turbidity on the
landward side. Submerged aquatic plants in the area include Eurasian Water - milfoil
(Myriophyllum sspicatum). The landward side skirting should be considered a bulkhead and as
such will reduce shoreline erosion. Enclosing the dock area will result in the encapturing of
509.25 square feet of public trust waters.
CAMA Review
The proposed project involves the public trust, estuarine waters and estuarine shoreline
areas of environmental concern. No historical/archeological significance is associated with this
lot. No endangered or threatened species of plant or animals have been identified in the project
area. The lot is not part of any unique geologic formation. There are no submerged aquatic
vegetation beds within the projected work area.
A consistency review of the project with the Perquimans County Land Use Plan will be
sent under separate letterhead.
Submitted by: Frank A. Jennings, III
Date: July 19, 1995
Form DCM-MP-1
APPLICATIONF,
rCj ?
(To be completed by all applicants) 4 {?
1. APPLICANT
a. Landowner:
Fax
?b` Authorized Agent:
Name
Name z/C g'(4l2 E) / P141M.
Address
City
State
b. qiyy?t/on,? i -or iattdmark k 1)
c. Street addres or secondary road number
d. Is proposed work within c! amts or planning
jurisdiction? \ Yes No
e. Name of body of w ter nearest project Le.g. fiver,
creek, sound, bay? F N pr) (Q /1
3. DESCRIPTION AND PLANNED USE
OF PROPOSED PROJECT
a. List all development activities you propose (e.g.
building a home, motel, marina, bulkhead, pier, and
excav tion and/or filling activities.
0
Zip Day Phone b. Is the proposed activity maintenance o an existing
project, new work, or both?
Fax
,! Project name (if any)
NOTE: Permit will be issued in name of landowner(s), and/or
project name.
2. LOCATION OF PROPOSED
PROJECT
a. County
:?_ State Al, J,
Phone ?t -,5K2_ 2-
c. Will roject be for public, private or commercial
use? P? I LA-`T!
d. Give a brief description of purpose, use, methods of
construction and daily operations of proposed
project. If more ace is needed please attach
alklitional pa
1 E
r*EtQ ps.
AlErhzk5D
;by t RoPt?z1-Y _b_okur
Revised 03/95
Form DCM-MP-1
4. LAND AND WATER
CHARACTERISTICS
i , rP Fifr, ri
J
v " u L-a
_
a. Size of entire tract 1't?? X 1 (?J
b. Size of individual lot(s)
c. Approximate elgvation of tract above MHW or
NWL
Describe existin wastewater treatment facilities.
5C PT l C'. ?V.?
n. Describe location and type of discharges to waters
of the state. (For example, surface runoff, sanitary
wastewater, industrial /commercial effluent, "wash
down" and residend discharg )
d. So' t e(s) apd to to e(s of tract o. Wscribe existing drinking water supply source.
A ?'D C- (? 11 1
e. Vegetation on tract lam. L C? /
f. Man-made features; now on tract
0 What is the CAMA Land Use Plan land
classification of the site? (Consult the local land use plan.)
Conservation
Developed
Rural
Transitional
Community
Other
h. How is the act ned by local government?
'PLAAMIAX C'??mM ill-LL
i. Is the propose?.project consistent with the applicable
zoning? ?? Yes No
(Attach zoning compliance certificate, if applicable)
Has a professional
done for the tract?
If yes, by whom?.
archaeological asses ment been
Yes No
k. Is the project located in a National Registered
Historic District or does it involve a National
Register listed o?rAible property?
Yes No
Are there wetlands on the site? Yes No
Coastal (marsh) Other ' 'LkO y
If yes, has a delineation been conducted?
(Attach documentation, if available)
5. ADDITIONAL INFORMATION
In addition to the completed application form, the
following items must be submitted:
• A copy of the deed (with state application only) or
other instrument under which the applicant claims title
to the affected properties. If the applicant is not
claiming to be the owner of said property, then
forward a copy of the deed or other instrument under
which the owner claims title, plus written permission
from the owner to carry out the project.
• An accurate, dated work plat (including plan view
and cross-sectional drawings) drawn to scale in black
ink on an 8 1/2" by 11" white paper. (Refer to
Coastal Resources Commission Rule 7J.0203 for a
detailed description.) 4 UL {-1-J
Please note that original drawings are preferred and
only high quality copies will be accepted. Blue-line
prints or other larger plats are acceptable only if an
adequate number of quality copies are provided by
applicant. (Contact the U.S. Army Corps of
Engineers regarding that agency's use of larger
drawings.) A site or location map is a part of plat
requirements and it must be sufficiently detailed to
guide agency personnel unfamiliar with the area to the
Revised 03/95
Form DCM-MP-1
site. Include highway or secondary road (SR)
numbers, landmarks, and the like.
Certification, if one is necessary.
A Storm 14"
•
•
A list of the names and complete addresses of the
adjacent waterfront (riparian) landowners and
signed return receipts as proof that such owners
have received a copy of the application and plats
by certified mail. Such landowners must be advised
that they have 30 days in which to submit comments
on the proposed project to the Division of Coastal
Management. Upon signing this form, the applicant
further certifies that such notice has been provided.
Name
` , O N&) f} D
Address J
Phone - D " A fj
Name •S , M
f}?t
Address 1 y LJ?J
Phone D4 - $ I _,q 6 0 .'?) e it. Ypr
Name
Address
Phone
• A list of previous state or federal permits issued for'
work on the projecf tract. Include permit numbers,
permittee, and issuing dates.
N cb s k-t -k- OR
• A check for $250 made payable to the Department of
Environment, Health, and Natural Resources
' (DEHNR) to cover the costs of processing the
application.
• A signed hazard notice for projects in
oceanfront i t areas.
• A statem of com lance with the N.C.
Environments. olicy ct (N.C.G.S. 113A - 1 to
10) If the project oIves the expenditure of public
funds or use pu 'c lands, attach a statement
documenting compliance with the North Carolina
Environmental Policy Act.
6. CERTIFICATION AND PERMISSION
TO ENTER ON LAND
I understand that any permit issued in response to this
application will allow only the development described in
the application. The project will be subject to conditions
and restrictions contained in the permit.
I certify that to the best of my knowledge, the proposed
activity complies with the State of North Carolina's
approved Coastal Management Program and will be
conducted in a manner consistent with such program.
I certify that I am authorized to grant, and do in fact,
grant permission to representatives of state and federal
review agencies to enter on the aforementioned lands in
connection with evaluating information related to this
permit application and follow-up monitoring of the
project.
I further certify that the information provided in this
application is truthful to the best of my knowledge.
This is the day o 19 -
Print Nam !? ?? ?,J, ' PPP-,
Signature Landowner or Authorized Agent
5y
Please indicate attachments pertaining to your proposed
project.
DCM MP-2 Excavation and Fill Information
DCM MP-3 Upland Development
DCM MP-4 Structures Information
DCM MP-5 Bridges and Culverts
DCM MP-6 Marina Development
NOTE. Please sign and date each attachment in the
space provided at the bottom of each form.
i
Revised 03/95
Form DCM-MP4
STRUCTURES
(Construction within Public Trust Areas)
Attach this form to Joint Application for CAMA Major
Permit, Form DCM-MP-1. Be sure to complete all
other sections of the Joint Application which relate to
this proposed project.
Dock(s) and/or Pier(s)
(1) _ Commercial -Community
(2) Number
(3) Length
(4) Width Q'12- " f
(5) Finger Piers Yes
X Private
No
(i) Number
(ii) Length f.
(iii) Width
(6) Platform(s) Yes No
(i) Number
(ii) Length
(iii) Width
(7) Number of slips proposed A/ A g.
(8) Proximity of structure to adjacent riparian
property lines' O I F_ ?'115'/AiQTH
(9) Width of water body
(10) Water depth at waterward end of pier at
MLW or NWL 7/
b. Boathouse (including covered lifts)
(1) Commercial- Private
(2) Length
(3) Width
c. Groin (e.g. wood, sheetpile, etc.)
(1) Number
(2) Length(s)
Breakwater (e.g. wood, sheetpile, etc.)
-?
(1) Length
(2) Average dis ance from MHW, ® or
wetlands Or P- (3) Maximum deaance beyond MHW, or
wetlands
ke??6.? v?aovc. N GJ L 3
Mooring buoys
(1) _ Commercial, -Community _ Private
(2) Number IV?t
(3) Description of buoy
(Color, inscription, size, anchor, etc.)
(4) Width of water body
(5) Distance buoy(s) to be placed beyond
shoreline
Mooring structure (boatlift, mooring pilings, etc.)
(1) _ Commercial -Community _ Private
(2) Number
(3) Length
(4) Width
Other (Give complete description)

Applicant or Project me
//7
Signature
6 - /Z - y?
Date
AULL i

Revised 03/95

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- J
DIVISION OF COASTAL MANAGEMENT j;, [I
FIELD INVESTIGATION REPORT

1. APPLICANT'S NAME: Richard Parr
2. LOCATION OF PROJECT SITE: Perquimans County, Holiday Island, Lot 21, Sec. A21, on
Southward Lane, man-made canal on Albemarle Sound
Photo Index - 1989: 1-16, 4 (013) 1984: 114-792
State Plane Coordinates - X: 2771800 Y: 85375
3. INVESTIGATION TYPE: CAMA
4. INVESTIGATIVE PROCEDURE: Dates of Site Visit - 07/12/95
Was Applicant Present - Yes
5. PROCESSING PROCEDURE: Application Received - June 12, 1995
Office - Elizabeth City
6. SITE DESCRIPTION:
(A) Local Land Use Plan - Perquimans County
Land Classification From LUP - Conservation
(B) AEC(s) Involved: PT, EW, ES
(C) Water Dependent: Yes
(D) Intended Use: Private/Residential
(E) Wastewater Treatment: Existing - Septic system
Planned - Same (no change)
(F) Type of Structures: Existing - House, sited and pier
Planned - Enclose around base of pier only
(G) Estimated Annual Rate of Erosion: Less than V
Source - Applicant
7. HABITAT DESCRIPTION: [AREA]
DREDGED FILLED
OTHER
(A) Vegetated Wetlands
(B) Non-Vegetated Wetlands
(C) Other
Public Trust/Estuarine Waters
Captured
509.25 square feet
(D) Total Area Disturbed: 509.25 square feet
(E) Primary Nursery Area: No
(F) Water Classification: SB Open: No
8. PROJECT SUMMARY: The applicant proposes to enclose around the base of an existing pier 48.5'
x 10.5', extending 10.5' into a man-made canal approximately 65' wide.
P,
Form DCM-M -1
APPLICATIO
(To be completed b all applicants) Y
1. APPLICANT
a. Landowner:
b. yy M n or iatidmark
c. Street address or second road number
?C-)67"'?1 TCLI, AV y-15 ,-+ND
d. Is proposed work within city units or planning
jurisdiction? \ Yes No
Fax
Authorized Agent:
Name
Address
State 3 ,
Phone 4,,J, d - 2-
City
Zip Day Phone
Fax
-! Project name (if any)
State
NOTE. Permit will be issued in name of landowner(s), and/or
project name.
2. LOCATION OF PROPOSED
PROJECT
a. County /
e. Name of body of w ter nearest project e.g. river,
creek, sound, bay) k -BEN 64 le (. E r)l.Q /1 D
3. DESCRIPTION AND PLANNED USE
OF PROPOSED PROJECT
List all development activities you propose (e.g.
building a home, motel, marina, bulkhead, pier, and
excav tion and/or fillin activities.
1
c
b. Is the proposed activity maintenance o an existing
project, new work, or both?
c. Will die-project be for public, private or commercial
use? 2l LAZ
d. Give a brief description of purpose, use, methods of
construction and daily operations of proposed
project. If more ace is needed please attach
a0ditional pa 1 E _
/v 4 Pr /S. V 4'. 5 vi k)
/l
1, jA Y , / r lP - % .r n &10/)
;5Y t RoP?,-17-Y D0.6 r
Revised 03/95
NameWZCZ?i4l2D
Richard H. Parr
Bio Report
Page Two
Site Description
The applicant owns a lot approximately .30 acres on a 65 ' wide man-made canal in the
Holiday Island Subdivision, Perquimans County. The lot is located in a neighborhood of
developed and undeveloped lots of similar size. The developed lots have both seasonal and year
round residences. The canal empties into the Albemarle Sound. Utilities include county water.
Sewage is handled by a septic tank and drainfield.
The shoreline elevation is approximately 6 inches above the normal water level (NWL)
of the canal. An area of approximately 750 square feet may be "404" wetlands. The applicant
states that the USACOE has been on site "years ago" but does not remember exact location of
"404" delineation. The lot rises to approximately 4 feet above NWL along Soundward Lane.
The soils on the lot have a silt loam texture. Vegetation on the lot consists of yard
grasses and loblolly pine (Pinus taeda). The waters of the canal are classified by NC DEM as
SB and are part of CAMA's Estuarine System Area of Environmental Concern.
Man-made features on the applicant's lot consist of a 30' x 36' private residence and a
101/2' x 481/2' wooden dock with a raised wooden walkway leading from the yard to the dock.
A CAMA exemption was written, by this office, May 29, 1992 for the dock and walkway.
The applicant proposes to enclose his dock underneath the outside edge by nailing boards
placed vertically from the dock underside to below the NWL. Much as mobile homeowners
place skirting around the foundations of their homes for aesthetic purposes, the applicant wishes
to accomplish the same. This skirting will not touch the bottom according to the applicant.
Anticipated Impacts
Construction of the proposed skirting will cause temporary water turbidity on the
landward side. Submerged aquatic plants in the area include Eurasian Water - milfoil
(Myriophyllum spicatum). The landward side skirting should be considered a bulkhead and as
such will reduce shoreline erosion. Enclosing the dock area will result in the encapturing of
509.25 square feet of public trust waters.
CAMA Review
The proposed project involves the public trust, estuarine waters and estuarine shoreline
areas of environmental concern. No historical/archeological significance is associated with this
lot. No endangered or threatened species of plant or animals have been identified in the project
area. The lot is not part of any unique geologic formation. There are no submerged aquatic
vegetation beds within the projected work area.
A consistency review of the project with the Perquimans County Land Use Plan will be
sent under separate letterhead.
Submitted by: Frank A. Jennings, III
Date: July 19, 1995

Form DCM-MP-1

4. LAND AND WATER
CHARACTERISTICS
v_W _----------
Size of entire tract
Size of individual lot(s)
c. Approximate *vation of tract above MHW or
NWL `` [
So' type(s). apd to to e(s of tract
LAq c
Vegetation on tract Cm a- L;5 /72 E_ L5
f. Man-made fea res now on tract 140 tj,
0 What is the CAMA Land Use Plan land
classification of the site? (Consult the local rand use pron.)
Conservation Transitional
Developed Community
Rural Other
h. Haw. is the act honed by local government?
IA)(- Nmm i77TLP
i. Is the propos project consistent with the applicable
zoning? ? Yes No
(Attach zoning compliance certificate, if applicable)
Has a professional
done for the tract?
If yes, by whom? .
archaeological asses ent been
Yes VNo
k. Is the project located in a National Registered
Historic District or does it involve a National
Register listed or able property?
Yes V4 No
1. Are there wetlands on the site? Yes No
Coastal (marsh) Other' yoy
If yes, has a delineation been conducted?
(Attach documentation, if available)
Revised 03/95
Describe existing wastewater treatment facilities.
n. Describe location and type of discharges to waters
of the state. (For example, surface runoff, sanitary
wastewater, industrial /commercial effluent, "wash
down" and residentW discharges )
o. Describe existing drinking water supply source.
5. ADDITIONAL INFORMATION
In addition to the completed application form, the
following items must be submitted:
• A copy of the deed (with state application only) or
other instrument under which the applicant claims title
to the affected properties. If the applicant is not
claiming to be the owner of said property, then
forward a copy of the deed or other instrument under
which the owner claims title, plus written permission
from the owner to carry out the project.
• An accurate, dated work plat (including plan view
and cross-sectional drawings) drawn to scale in black
ink on an 8 1/2" by 11" white paper. (Refer to
Coastal Resources Commission Rule 7J.0203 for a
detailed description.) + ?G,brA V, It.--J
Please note that original drawings are preferred and
only high quality copies will be accepted. Blue-line
prints or other larger plats are acceptable only if an
adequate number of quality copies are provided by
applicant. (Contact the U.S. Army Corps of
Engineers regarding that agency's use of larger
drawings.) A site or location map is a part of plat
requirements and it must be sufficiently detailed to
guide agency personnel unfamiliar with the area to the
Form DCM-MP-1
site. Include highway or secondary road (SR)
numbers, landmarks, and the like.
• A Storm er Certification, if one is necessary.
• A list of the names and complete addresses of the
adjacent waterfront (riparian) landowners and
signed return receipts as proof that such owners
have received a copy of the application and plats
by certified mail. Such landowners must be advised
that they have 30 days in which to submit comments
on the proposed project to the Division of Coastal
Management. Upon signing this form, the applicant
further certifies that such notice has been provided.
Name -1. rZ i4L_BGR T0 C A5-1-ftI)EDA
Address N N [+D Qe? 1 ,
Phone C 14 -34 D" 3 A,- bCk \1 A
Name .S , M
Address t 1 F_ 1C Au
Phone D- 1' D 11
Name
Address
Phone
• A list of previous state or federal permits issued for'
work on the projecf tract. Include permit numbers,
permittee, and issuing dates.
• A check for $250 made payable to the Department of
Environment, Health,, and Natural Resources
(DEHNR) to cover the costs of processing the
application.
• A signed hazard notice for projects in
oceanfront t areas.
• A statem of com lance with the N.C.
Environments olicy ct (N.C.G.S. 113A - 1 to
10) If the project olves the expenditure of public
funds or use pu 'c lands, attach a statement
documenting compliance with the North Carolina
Environmental Policy Act.
6. CERTIFICATION AND PERMISSION
TO ENTER ON LAND
I understand that any permit issued in response to this
application will allow only the development described in
the application. The project will be subject to conditions
and restrictions contained in the permit.
I certify that to the best of my knowledge, the proposed
activity complies with the State of North Carolina's
approved Coastal Management Program and will be
conducted in a manner consistent with such program.
I certify that I am authorized to grant, and do in fact,
grant permission to representatives of state and federal
review agencies to enter on the aforementioned lands in
connection with evaluating information related to this
permit application and follow-up monitoring of the
project.
I further certify that the information provided in this
application is truthful to the best of my knowledge.
This is the day o til.-Q , 19.
Print Nam 'A ?iAL9ZL
Signature l-
Landowner or Authorized Agent
Please indicate attachments pertaining to your proposed
project.
DCM MP-2 Excavation and Fill Information
DCM MP-3 Upland Development
DCM MP4 Structures Information
DCM MP-5 Bridges and Culverts
DCM MP-6 Marina Development
NOTE. Please sign and date each attachment in the
space provided at the bottom of each form.
------------------ ------
Revised 03/95
Form DCM-MP4
STRUCTURES
(Construction within Public Trust Areas)
Attach this form to Joint Application for CAMA Major
Permit, Form DCM-MP-1. Be sure to complete all
other sections of the Joint Application which relate to
this proposed project.
a. Dock(s) and/or Pier(s)
(1) _ Commercial -Community X Private
(2) Number
(3) Length 1
(4) Width 10722
(5) Finger Piers Yes No
(i) Number
(ii) Length
(iii) Width
(6) Platform(s) Yes No
(i) Number
(ii) Length
(iii) Width
(7) Number of slips proposed Al A
(8) Proximity of structure to adjacent riparian
property I ines `1. D I F L N D R.TH
(9) Width of water body
(10) Water depth at waterward end of pier at
MLW or NWL
Boathouse (including covered lifts)
(1) Commercial W_ Private
(2) Length
(3) Width
Groin (e.g. wood, sheetpile, etc.)
(1) Number
(2) Length(s)
)0d Breakwater (e.g. wood, sheetpile, etc.)
(1) Length !?Z
(2) Average distance from MHW, (? or
wetlands >? j
(3) Maximum d'taance beyond MHW, or lao wetlands
1-le.,+V N u..> L z _3 i
e. Mooring buoys
(1) _ Commercial -Community _ Private
(2) Number X74
(3) Description of buoy
(Color, inscription, size, anchor, etc.)
(4) Width of water body
(5) Distance buoy(s) to be placed beyond
shoreline
f. Mooring structure (boatlift, mooring pilings, etc.)
(1) _ Commercial -Community _ Private
(2) Number
(3) Length
(4) Width
g. Other (Give complete description)
Applicant or t re
Signature
12 - ??
Date

O !
in ..

Revised 03/95

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