HomeMy WebLinkAbout73511D - BlankenshipXCAMA / ❑ DREDGE & FILL �`� \0. No. 73511 A B C Q
GENERAL PERMIT Previous permit #
Pevv ❑Modification El 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 pursuant to I SA NCAC 07 H 1.200
pp 7 Rules attached.
Applicant Name M lCgAE I- be LAL.Ri's< 6 LNn/ ICICNS►+l IP
Address 141 (i DA I S Y V O
City LnRIs State SC ZIP2g5(,q
Phone #( 43) S 5- 87& 3 E-Mail M 1A
Authorized Agent S,q MM y VA RNA M
Affected ❑ CW XEW IXPTA ❑ ES ❑ PTS
AECI ❑ OEA ❑ HHF ❑ IH ❑ URA ❑ N/A
❑ PWs:
ORW: yes / no PNA yes no
Project Location: County 'E "I c V.
Street Address/ State Road/ Lot #(s) 2 5
SEA .YVI P O. lD 5 W
Subdivision H /,A
City S"r pw ZIP 2 84-& 2
A4L,4-T Phone # ( 910) 4-43 - 424S River Basin LNtAmw_
Adj. Wtr. Body A I W W /unkn)
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Agent or pli -avV
t rimed Name
ignat ** Please read compliance statement on back of permit's
* 200 4+ 7530
Application Fee(s) Check #
I Y LER MC �I.IIRE
Permit Officer's Print Name
C
Signature
4 / 9 . A9 C11 19
Issuing Date Expiration Date
NCDER
North Carolina Deoartment of Environment and Naturai Resources
_ Division of Coastal Management c
�icheel F. Easley, Governor Charles S. Jones, Director :',;!,am V. "(Qss Jr.. Secret ary
Authorized Agent Consent Agreement
's hereby authorized to act on my behalf
(Printed Name o.'Agent)
in order to cbtain any CAMA permits} required for the property listed below. Tie authorization is limited to the
;oecific activities described in the attached sketch.
LOCATION Or PROJECT:
L- -i rc�11con PT r L
?ROPERTY OWNER 'AAIL!NG ADDRESS:
Zk
, 1-4
PHONE NO. '8
AUTHORIZE} AGENT (MAILING ADDRESS:
61 w V ill i"Mo ryl
�S79 111c1^15�er j'ak Est Ik.1 L&I
iUc a ye
Signature of Property
PHONE NO.
Signature of Authorized Agent:
Date'
.27 Cardinal Drive Ext., ',4i!wgton, Ncrin :araina 28405-3845
acne: .�'•C-g&'2'5 =AX. 9?0-3g5-s964 %,terrer. :/14'N.i':C J3Si2i: 3f 2geR Eni.t�et
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Tracking Number: 70180680000070243572
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March 25, 2019 at 2:21 pm
Delivered, Left with Individual
MINEOLA, NY 11501
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March 25, 2019, 2:21 pm
Delivered, Left with Individual
MINEOLA, NY 11501
Your item was delivered to an individual at the address at 2:21 pm on March 25, 2019 in MINEOLA, NY
11501.
March 25, 2019, 10:15 am
Out for Delivery
MINEOLA, NY 11501
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Tracking Number: 70180680000070243589
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CERTIFIED MAILP RECEIPT
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m For delivery information, visit our website at www.usps.corn�.
by
n I Certified Mall Fee
MARCH
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2320190 8 ■ 00 P m O
$
Extra Services & Fees (checktwx, ad fee all e)
❑ Return Receipt (hardcopY)
0
C ❑ Retum Receipt (electmnk) $ Postmark
0 []Certified Mail Restricted Delivery $ Here
Q []Adult Signature Required $ L
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❑Adult Signature Restricted Dellv $
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OV Delivered
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March 23, 2019 at 12:38 pm
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Delivered, Left with Individual
si�eq� Pt_ - ' _ ,°" °. - - - -----------------------------------
SUPPLY, NC 28462
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March 23, 2019, 12:38 pm
Delivered, Left with Individual
SUPPLY, NC 28462
Your item was delivered to an individual at the address at 12:38 pm on March 23, 2019 in SUPPLY, NC
28462.
March 23, 2019, 8:59 am
Out for Delivery
SUPPLY, NC 28462
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Date ReceivM
Date Deposited Check From Name
Name o/Permit Holder
Vendor
Check Number
Check
amount
Permit Numb —Comments
Rece/pt or Refund/Reallocated
Columnf
Column2 Column3
Column!
Columns
Column6
I Column?
Col.-8
Column9
4/10 1
Vamam ks and ulkheads
Mwhael and 11 Blankenshty
7530 S TM
■ Complete items 1, 2, and 3. - LA.161rrtiture
■ Print your name and address on the reverse A&J-1-1
C7 Agent
so that we can return the card to you, ❑Addressee,
® Attach this card to the back of the�n-ailpiece, B. ivatibY (p rrfed ame) C. Date of Delivery
or on the front if space permits.
1. Article Addressed to: D. 1s delivery address different from item i? ❑ Yea
if YES, enter delivery address below. ❑ NO
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3. Service Type 0
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t on Delivery Restricted Delivery 0
7018 0680 0000 7024 3572 Imall 13
Mail Rest #eted balNery
over
PS Form 3811, July 2015 PSN 7WO-02-000-9053 5 Don
Complete Items 1,'2 and 3 `
■ Print your name and address on the reverse
so that we can return the -card to you.
■ Attach this card to the back of the mallpioce,
or on the front if space permits,
1. ArticieAddressed:�sj�
Ill Illlll Illl 1II I II it#ll Illlll �If ill �I11 i l III
9590 9402 4454 8248 7544 74
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If YES, enter delivery address
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3. Service Type
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❑ AdultSignaturs Restricted DOmy
11 Gatfled MalM
❑ Registered MaT
0 g:gW ed jyA1
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0 Collect on Delivery
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❑ Collect on Delivery Restricted Delivery
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