HomeMy WebLinkAbout72878D - Satorre-!CAMA / '❑ DREDGE & FILL NO. 72878 A B C
GENERAL PERMIT Previous permit #
�"w ❑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 pursuant to I SA NCAC
Ri Jne ."t Klmd
Applicant Name /� /y SA T G/xx-c
Address 5?/7 /` GUGD X "'C` Rcal,
City k e State "fC ZIP .Z �yy�
Phone # (��U) 23/-3S".J� E-Mail
Authorized Agent
❑ CW
;4W
9_PTA ❑ ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
� V
ORW: yes / �o
PNA
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Project Location: County
Street Address/ State Road/ Lot #(s)
9 1 v 4 ,, �P,,c/ .7,k
Subdivision F,
City ZIP.2792s F
Phone # ( ) River Basin C,4 ,PL
Adj. Wtr. Body . . b 67 / U 0,1 dna /man /unkn)
Closest Maj. Wtr. Body —/AV, C ' �i91�CfC"'Oy "f)y w
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orAoolicant Printed Name
Si re ** Please read compliance statement on back of permit **
Application Fee(s) Check #
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Officer's Printed Name e ,2_--�--
Signature
jh 7 -71
1 ing Did'Expiration Date
AGENT AUTHORIZATION FOR.CAMA PERMIT APPLICA%' ON
Name of Property Owner Requesting Permit: Kim Satorre
Mailing Address: 588 Lightwood Knot Rd.
Kelly, NC 28448
Phone Number:
Email Address:
I certify that I have authorized Joel Kies
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: installing deck, ramp, & floating dock
at my property located at ...Lot 6 Riverbend. Dr. eurgaw
in Pender County.
I furthermore car* 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 albrementioned lands in connection with evaluating information related to this
permit application.
Property Owner Infornuffon:
Tae
Date
2 This certification is valid through __ _/ 2,0 /
■ 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 mailpiece,
or on the front if space permits.
1. Article Addressed to:
b
Jeanne S. Carter > c,,7�'O
205 King Arthur Dr. °0:
Wilmington, NC 28403-
11111111111111111111111111111111111111111111111111111111
9590 9402 1911 6104 9102 47
2. Article Number (transfer from service label)
7016 1370 0000 4733 0385
PS Form 3811, July 2015 PSN 7530-02-000-9053
■ 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 mailpiece,
or on the front if space permits.
1. Article Addressed to:
David & Michael Bollinger
1695 Riverbend Dr.
Burgaw, NC 28425
A. Sign ture
❑ Agent
X �'-L." ❑ Addressee
B. R el d by (Printed Name) C. D to of Delivery
D. Is d very address different from item 1? PKYes
If YES, enter delivery address below: ❑ No
'17
3. Service Type
❑ Priority Mail Express®
❑ Adult Signature
❑ Registered MaiITM
❑ Adult Signature Restricted Delivery
❑ Registered Mail Restricted
❑ Certified Mail(D
❑ Certified Mail Restricted Delivery
Delivery
O Return Receipt for
❑ Collect on Delivery
Merchandise
Signature Confirmation TM
❑ Collect on Delivery Restricted Delivery
❑ Signature Confirmation
m 1_jred Mail
gyred Mail Restricted Delivery
Restricted Delivery
r $500)
Domestic Return Receipt
A 7RY
cj j
❑ Agent �
X ❑ Addressri 4 e);. Date of Delivel!
DECC 19
D. Is delivery address iffere om item 1? ❑ Yes
If YES, enter delive addW below: [I No
3. Service Type
❑ Priority Mail Express®
III
IIIIII
IIII
11111111,
IIIIIIII
111111111,111111,
I I
I I
I
❑ Adult Signature
❑ Adult Signature Restricted Delivery
❑ Registered MaiITM
❑ Registered Mail Restricted
9590 9402 1911 6104 9102 30
❑ Certified Mail(D
❑ Certified Mail Restricted Delivery
Delivery
❑ Return Receipt for
Merchandise
❑ Collect on Delivery
❑ Collect on Delivery Restricted Delivery
0 Signature Confirmation TM
2. Article Number (Transfer from service label)
— ured Mail
❑ Signature Confirmation
0 1� 6 1, 3 7 0 0 0 0 0 4 7 3 3 0 3 3 0
ured Mail Restricted Delivery
er $500)
Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
Date Recelved
Date Deposited
Check From (Name)
Name of Permit Holder
Vendor
Check Number
Check
amount
Permit NumbenComments
Recel t w Refund/Reallocated
Columnf
Column2 1 Column3
Columnl
Column5
Column6
Column?
Column8
Column8
01
Joel lass MoneyOrder
m Sa orre
_
USPS
253348676101
00.00
GP a72878D