Piggott, Thomas A.

®F-CAMA / DREDGE & FILL I I 1 I ((No. 75230 A B C D
GENERAL PERMIT Previous permit#
FINeW - ❑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 p r�uant to 15A NCAC
❑ Rules attached.
Applicant Name_ _ / i iProject Location: County _
Address
City__ ! ,!
State ZIP
Phone #
E-Mail
'
Authorized Agent
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Affected
AEC(s): Ll OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ P/WS:
ORW: yes / lnp
PNA
yes / fir
Type of Project/ Activity
PierLdw
Fix.
Float
Fing
Groff
Bulk
Basin
Boat
Boat
Beac
Oth -11
Shor
SAV.
Mon
Phot
Wait/
Street Address/ Sta a Road/ Lot #(s)
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Phone #
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Closest Mal. Wtr.
ZIP
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A building permit may be required by. -
Note Local Planning jurisdiction)
Notes/ Special Conditions
r
A -4,'
Agent or Applicant Printed Name
Signature *" Please read compl'i�nce statement on back of permit
Application Fee(s) Check #
❑ See note on back regarding River Basin rules.
Permit Officer's Printed
Signature

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:���/� y
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: OFcAcf ;7o<[-
/n- S/ rF /cr,- f.%iiivG t<XrsTi/v6 !7/Cin/6S-
at my property located at ZOV &rv/ll✓ X,1V,>17-egN-.,7C Ke oe,v
in County.
l furthemrore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Properly Owner Information:
Signature
i
Pririt 6r Type ¢fafne `
Title
—�ZILZZI�
Date
This certification is valid through--

Styron, Heather M.
s
From: [e-mail]
Sent: Thursday, August 01, 2019 1:11 PM
To: Styron, Heather M.
Subject: [External] 224 Bayview Agent Authorization
Attachments: Doc 08-01-2019 13-09-55.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an
attachment to repo [e-mail]<maiIto: [e-mail]>
Hey Heather,
I need a permit for this. We are doing same foot print using existing pilings
Thanks
Andre
Sent from my iPhone
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