71252_Port Trinitie Association_20181116

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[�CAMA /❑ DREDGE & FILL 2 7 l 252 6p B C D
GENERAL PERMIT Previous permit#
L 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 N . a uV
Rules attached.
Applicant Name Pori ?i , nTV ASS�c�ai 1
Address NO dox 14 6
City 1L,State tic ZIP a Ci 49
Phone # ( ) E-Mail
Authorized Agent 0 E mo ✓ • M
Affected ❑ CW ❑ EW ❑ PTA t�ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS:
ORW: yesj PNA yes no
Project Location: County be. i C
Street Address/ State Road/ Lot #(s) ) Lion-1 9cl
iN l - 1 d- r,rv. Mov-� Of'c, /
Subdivision Ro{ 1 -7 r�" •i y
City fJ„ c IL ZIP 017; G L 5
Phone # ( ) River Basin _PIS4L,Q-�'
Adj. Wtr. Body nat>nan /unkn)
Closest Maj. Wtr. Body �' r►`-�r
Apat.or Applicant Printed Name , Permit Officer's Pri ame
$(� I't -, a &r� GAA� —
signal "Please read compliance statement on -back of permit" ure
Application Fee(s) Check # Issuing Date t piration Date

N.G. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date /% S" / 9
Name of Property Owner Applying for Permit:
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Matting Addr m:
P.O. 30 it
Iq 4 s
2'7 14-t 4
I oerdfy that I have authorized (agent) ` E Mar I Y) f, to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
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Install or construct (activity) Cd)f4- F1eu: W1 41�1 C�Ce_rV
re bt i..1. I ),
at (my property located at) D -c-_ � P d
�Dr-�TYin4Lj Sub U►StOn �1
This certification is valid thru (date)
Property O„
40WMW� +t e j
A64- rho" tw Hoot
Date

FIT
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