Marshall, Grover

®LICAMA / ❑ DREDGE & FILL `-._—No. 75727 A B C D
ENERAL ,PERMIT Prevfouspermit#
Jew ❑Modif cation ❑Complete Reissue ❑Partial Reissue Date previous permit issued
II p 7,
As authorized by the State of North Carolina, Department'df Environmental Quality JI -
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
—' (`� ❑ Rules attached.
Applicant Name 14 j L`...\.Project Location: County
Address i t Street Address/ State Road/ Lot #(s)
City L_A -� i)_1.,1 ) State J ZIP.
Phone # ( j' )I " ) E�11ai� Subdivision
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Authorized Agent j ( i (lIc(.. 1 i �) City - ZIP_
Affected O Cw ElEW El PTA Li ES ElPTS Phone # ( ) River Basin +
AEC(s): El OEA ❑ HHF ❑ IH D UBA ❑ N/A qAdj. Wtr. Body__ _ _ _ _ (nat /man /unkn)
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ORW: (' yes /I)no PNA yes / ro l Closest Maj. Wtr. Body - -- -
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Signature Please read compliance statement on backof permit"
Application Fee(s) Check #
L.�
Date

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit:
Mailing address: _ /Oy
Telephone Number:
I certify that I have authorized ( nyu�itnc � m� [,hc_, (agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of flew - �-oY\ cA-etp t d-
at my property located at
This certification is valid through 07 - '-) O —1 (3 (date).
(Property Owner Information)
Signature
Print or Type Name
v Le�11/` r
Title, co. owner or trustee for property
1�z l — 21--)/Ff
Date
yi- 3i 7
Telephone Number
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Efnail A dress
RECEIVED
SEP 2 4 2019
DCM-MWD CITY

TOMMY MARSHALL
100 WATERFRONT AVENUE
NEWPORT, NC
DESCRIPTION
We propose to install a new concrete pier consisting of a 5' wide x 140' long
walkway connecting to a 13' wide x 20' long platform.
We propose to install a new 10" x 25' long piling for a jet ski lift.
RECEIVE®
SEP 2 4 2019
DCM.MHD CITY

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