Oakes, Robert

CAMA / ❑ DREDGE & FILL 4k t I ALP(�� ( NO. 74469
A B '' C D
GENERAL PERMIT Previous permit#
]New []Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Bhvirorltnental Quality
and the Coastal Reso tees commis sion.man area of environmental concern pursuant to 15A NCAC
1 ule attt ched.
Applicant Name Project Location: County _ f {J
Address 'r af Street Address/ State Road/ Lot +� #(s)
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City k h �� (1 , State ZIP /} / )
Phone # ( � (7 ,- 1 -Mail Subdivisigp
Authorized Agent �._._ City f (- ZIPS
Affected L ,�W �" g ❑ES ❑PTS Phone # ( f I /River Basin /
�OEA ❑HHF ❑I ❑UBA ❑N/A ' / I-< j
AEC(s): Adj. Wtr. Body (nat /man /unkn)
❑ PWS:�
ORW: yes / ,,no PNA yes / no Closest Maj. Wtr. Body-
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Type of Project/ Activity ' `'
(Scale: )
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A building permit may be required by::Ti
( Note Local Planning Jurisdiction)
Notes/ Special Conditions i Jy
IMENWAmr
Issuing
_ U See note on back regarding River Basin rules.
Name ,

Hurricane Florence and TS Michael
Replacemeut/,Repair Request Form
Date of Request: I
Property Owner Name: Koy(t O(i )(R.S
Address of Property: /n
Telephone Number: q 1�1- Q (q'-- 1-4 Q)R o
Type of Work: �L ((/(- CY-- r iQoba UTT
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:
A110 CHW-WOO
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