Abee, Robert

®J CAMA / ❑ DREDGE & FILL 0 No. 75988 A B c� D
GENERAL PERMIT y Previous permit#
I New ❑Modification []Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality / /-/ _ / T
and the Coastal Resources. om Ission in an area f environmental concern pursuant to I SA NCAC (..+�C d. (,J
%� / ❑Rules attached.
Applicant Name '� , / t"/ Project Location: County (s `MC r `-'
City fi IN r/" I:{ I ) ^ State ZIP
Phone # (;�Lj );A 1" y ll / E- all
Authorized Agent "-T '' J ,/ r ^ Q/c
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Agent or Applicant Printed Name
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Signature **Please read compliance statement on back of permit**
Signature
Application Fee(s) Check# Issuing DatA Expira ion Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: U --
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
d ��it Al (
5k�
Agent I
Z-26g--7
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 24414C CA
dx,5u �m}n�•,!
at my property located at 'I I to 59vAd W,
in Cc. kvrca- County.
1 furthermore certify" that l 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.
Property Owner Information:
Signature
j4x L, /bey
Print or Type Name
%�rlm��t.✓ne/
Title
I2 , 17 , 2o19
Date
This certification is valid through
RECEIVED
DEC 17 2019
-1)CM•MHD CITY

NC Division of Coastal Management
Hurricane Replacement/Repair Request Form
Date of Request: t2 & /14
Property Owner Name: �06a�
Address of Property: 7110 twwoi Ar, CAt�, Id .t s1(.- N_G
Telephone Number: 01 q , 602r - t,)c4
J, AgL'1
Type of Work: lc"Ll iS0' 1<�'
NOTE:
• The Emergency CAMA General Permit 2500 is for repairs and replacement of water -
dependent structures damaged because of a Hurricane. 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:
DECEIVED
DEC 17 2019
CC'°A-MHD CITY'

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