74851D - Boyd

r. CAMA / .rJ DREDGE &FILL
NO. 74851
A B C
GENERAL PERMIT
AL
Previous permit #
ANew' ❑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 15A NCAC
Applicant Name
❑ Rules attached.
Project Location: County
Address O 4 i u_ _ 1
Street Address/ State Road/Lot #(s)
City % -.... State ZIP 10
++
T.I.) r
Phone # �) _4� i E-Mail -- b�1 (u a IL, t o f-
Subdivision
Authorized Agent A --t i,- ,,..y _!s
City � �yl �� e a c I,1
ZIP
Affected ❑ CW [�J EW ® PTA p ES ❑ PTS
Phone # ( ) River
Basin
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ WA
AEC(s):
Adj. Wtr. Body CE,.a �
(nat 4n`an�unkn)
❑ PWS:
Closest Maj. Wtr. Body�1w`"�
ORW: yes / PNA yes /,ma
Type of Project/ Activity { Iy I �t _�. d IN r-x a (
Z , sJ�w �� o� �Okc I S
e c ell, 1�
(Scale: ►� ~T S )
Pier
Fixe
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Groff
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Boat
Boat
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Phot
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r4v?c�ed: Z_�U001MEMEME
No
mom
EMEME
mm�E
A building permit may be required by: J(v w.. �� of i , — be C. c h
( Note Local Planning Jurisdicti )
Notes/ Special Condition
Age or Applicant Printed Name
I>r 11 ��i�►,�Gs
Signatur* Please read compliance statement on back of permit ** SignatL
d0 p0 -030S1 `_?0(P j --A
Appli ionFee(s) Check# Issuing
❑ See note on back regarding River Basin rules.
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12/31/2019
Mail - Brock, Brendan O - Outlook
AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: �f ET JlC�/7> �`c_ 6 T
Mailing Address:
Phone Number:
Email Address
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
i
in County.
l furthermore certify that / 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:
d�
r ]
Signature
Print or Type Name
Title
,l 1 G l�
Date
This certification is valid through /G ! e-G / 2-Z-.,'
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12/31 /2019
Mail - Brock, Brendan O - Outlook
■ 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 bac:< of the ma4piece,
—or on the front if space permits.
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PS Form 3811, Jury 2015 PSN 7530-02-0pa9=
Domestic Return Receipt
• Complete items t, 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,
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Domestic Return Receipt
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Dare R—t-d
Date D9RoaNftd
ama
Name of Permit Holder
V dor
Check Number
Ch..k
amount
Permit Number/Commenb
Rac t or Rahlnd/Reallocafad
Cdemnl
Cokrmn2
Cok~3
Column)
Colomn5
Cof—d
Cdumn7
Cd—s
CoWmn9
1/17/2020
1 Wayne's Backhoe Service Inc.
!Gnce Construction
_ -j Maritime Coastal Construction LLC (1 of 2
Maritime Coastal Construction LLC (2 of 2
-
Maritime Coastal Construction LLC
Sweetwater Investments/Wayne S
First Bank
3362
$ 200.00
GP #74852D
GP #74848D
GP #74851 D
GP #74851 D
- -
GP #74849D
Tmac rct. 10876
BB rct. 8805
BB rct. 8802
BB rct. 8802
- -
BB rct 8801
1/17/2020
Christopher Smoll_en
BUT
CresCom Bank
13512
3064
$ 200.00
$ 200.00
-if
1/17/2020
Ste nie Boyd _
Stephanie Boyd
Glenmark Investments LLC
1/172020
CresCom Bank
Eli
000.00
1/17/2020
CresCom Bank
200.00