Mariners Point Partnership Howard, Sarah

❑CAMA / ❑ DREDGE & FILL NO. 75264
,_ (F_ A B C.
D
GENERAL PERMIT Previous permit#
WMPNew ❑Modification Ell 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 SA NCAC
O Rules attacped.
Applicant Name ; f i "' ' �'• j' - L.. t 11 Project Location: County `
Address f I " V Street Address/ State Road/ Lot #(s)
City / , fi -I ��" ,f'tl') i StateLJ ZIP
Phone # (' -) T / "' E-Mail Subdivision
Authorized Agent
Affected CW
AEC(s): OEA
❑ PWS
DEW ❑PTA Li ES ❑PTS
❑HHF GIH ❑UBA ❑N/A
ORW: yes / no PNA yes / no
City ZIP
Phone # O River Basing-'
Adj. Wtr. Body /man /unkn)
ti.,
Closest Maj. Wtr. Body ,'_ � i
............�CCCC■■C.0
■CC■■■■■■■■■■■
®®�MM.0 ■C ■■C�
m' ■■ ■■■
■■■■■■■■■■■■a■■■■■
■■■■■■■■■■■■■■■■■■w
■■■ra■■■■■■■
I■■■Mu■■■■■■■■
■■■■■
■■■■■■H■■■■■l41
■■■I�iI■■■■■■■■■■■■■■
■■■■■■■■■■ii■®■■®■■■Isw■■■.A■■■■■■■■■■■■■■
CCCCC■CCCIi�
�CCCCCCCC■■Cu®CCCCCCCCCCCC■'
■■■■■C■■■1:■■®■■.■■■CC
MO■■■■■■■■■■■■■CC
NONE C■■■■■■■M■■■■■■■■■■■C■■■■■■■■■■■■■�
CCMCCCCCCCCCCCCCCCCCCCCCC
CCCCCCCCCCCCC■
■0.■■■■CII.�+■■.........0
CC.�■.........
■H■■■■■■I�■
■■■■■■■■■■■■■
C■■■■■■C■■■■■■
■■■■■■®■II■E
■■■■■■®■■■■
■■■■■■■
C■■■■■■■■.
C.■■.■■C
CCa''''®C:C�®CC®.
CCC�
:CiCCCCC:CCCEC■nC■■■■■■C■
,�,•11 i�nl' r'j-/
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit Officer's Printed Name
Signature 1
Issuing Date Expiration Date

Hurricane Florence and TS Michael
Replacement/Repair Request Form
Date of Request: 1 r�
Property Owner Name:
Address of Property:
Telephone Number:
Type of Work:
NOTE:
The Emergency CAMA General Permit 2500 is for repairs and replacement of water -
dependent structures damaged because of Hurricane Florence and/or TS Michael. The
replacement, reconstruction and maintenance excavation activities shall conform to
current standards and rules. All work under the Emergency CAMA GP 2500 must be
made in the same footprint of the previous structure with no additions, expansions, or
enlargements.
• If any portion of a structure being replaced is within the 15' setback of the riparian line or
access area, signatures of the adjacent riparian property owner(s) must be obtained
acknowledging the notification and waiver of the setback on the forms provided by
DCM.
• Any maintenance excavation or dredging requires signatures of the adjacent riparian
property owner(s) on the notification forms provided by DCM.
Signature:
RECEIVED
AUG 12 2019
DCM-MHD CITY