75804D - Atkinson

)(CAMA / 7, DREDGE & FILL NO. 75804 A B C
GENERAL PERMIT Previous permit#
)(New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality �� 114`lJ�
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name Fr""
FrA" k �7 Wl'h Sb ►'\
Q
Address I & &P•4^Qe\s eV Rd SVJ
Project Location: County �r �t►� C w lL� a/
Street Address/ State Road/ Lot #(s)
City S u State NL zip
Phone # )5 7 6 -Mail io GLAV ► kp 'fubdivision
Authorized Agent C7f lq �oi�e.V1 City t zip
Affected ❑ CW )(EW XPTA
AEC(s): ❑ OEA ❑ HHF ❑ IH
❑ PWS:
ORW: yes /ro )
❑ ES ❑ PTS Phone # ( River Basin L U w+ pe"
❑ UBA ❑ N/A Adj. Wtr. Body L t, c-k-W S r'�% �tt'� nat)/man /unkn)
PNA yes / no Closest Maj. Wtr. Body
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Signature reaU compliance statement on back of permitit;Oltaie
no - 3S a-!�
Application Fee(s) Check #
&YlBri'(NV_
Per 'Officer's 4Prildl Name
Signature
LiI � �O
Issuinj Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: F. t\ (4+ �< 1 Y) �'o n
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
L rf1D�'s
ki
*�C4- S~114-"1
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: e e c 4 -�
—r j U a J " \I- 1
d C-
at my property located at q e�� 1 �'S Pt , 1� Q�
in C&-,Qunty.
1 furthermore certify 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 aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
R, /T-f )�- t' /�
Print or Type Name
Title
V l� l�6
Date
This certification is valid through I I

2nme Of -Individual Appivm-:v , For I
MIEN
m Owl
R $'
IIim
=71
fS beimg P"Wmed2 please wrfte itke, DivW,..
of MIs WmWhmt9au6 WC 28405 or ca9-to u -39,
ums days reedpt - MCA& =WWP-
7m bait bom uvWxA by CW"ed ME-L
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vetbcka
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t bd9dthe Wpprepdaft bbml& below-)
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TdTham Nbmber wft Area

P. � .01, WA, � W.: --�

MU Rft-~
Deb
Check From Name
Name or Nrmm t Hddw
L Vendor
Check Number
Cfrock
amount
P.—it NumberlCwnmente
RecN t w Ref—Waalbceted
Culumni
Column2
Column3 _
C.4-4
I Column#
Cdumn7
Column#
Cdumn9
4/21/2020',
PFI Construction LLC
Mary, Denise, Michael Thomas Jot
Navy Federal CU
7032 $
600.00 GP #761030
JD rct. 10336
4/21/2020
Lighthouse Marine Constrction
:Doc and Ginny Kibler
Coastal Bank
_
3145 $
200.00 GP #75880D
JD rct. 10335
4/21/2020
Allied Marine Contractors LLC
'Charles Carlton
_ _
First Cdizens Bank
_
_ 8897 $
200,00 GP#75881D
JD rct. 10334
4/21/2020
Holden Docks and Bulkheads
Frank Atkinson
CresCom Bank
3829 $
200.00 GP #75804D
Bbrink rct 10869
4/21/2020
Grice Construction of Brunswock
Myra Dove
BB_8T
13765 $
200.00 GP #76118D
Bbrink rct. 10423
4/2112020
Grice Construction of Brunswick County In
Robert Moore
BB3�T
1376716
400.00 GP #75856D
_
Bbrink rct. 10424
4/21/2020
Grice Construction of Brunswick County In
Shelby Jordan
BUT
_
13766 $
400,00 GP #75857D
Bbrink rct. 10425
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Clements Marine Construction
Archie McGirt
_
BBBT
5407 $
40000 GP #76126D
PA rct 10356
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LA
Newton and Sally Baxter
Newt Baxter
Wels Fargo
7940 $
60000 GP 976408D
Bbrink rct 10422
21/2020
Susan Watson Cain
same
T
7942 $
600,00 GP 075879D
JD rct. 10831