69172D - Foust

�I'CAMA / ❑ DREDGE & FILL
GENERAL PERMIT ` `� Previous permit # A B
f`klew Modification ❑Complete Reissue --Partial Reissue Date revious permit issued
prized by the State of North Carolina, Department of Environment and Natural Resources 0-7 �. ( Z 5 O 0
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC /) 7 �7 - � q q
! F-,o
❑Rules attached.
nt Name )6 ►�1S/)t/s Project Location: County ��YiSLms Cly- t't Street Address/ State Road/ Lot #(s)
�T
k&41 O VrcQ State L ZIP 1'i 0 1.
. Ci t g 1 A Z a
of `1 ' v E-M�aiill n _ Subdivision Gk
zed Agent �d Y1_(AS_ 1�� �Ci� ���1Vt k ZIP
ElCW )(PTA ❑ ES ElPTS Phone (� (�) �a' oy 10River Basin L VW
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body 0 t S0 Wt d Cry r- UQ
❑ PWS:
yes / 6PNA yes /
Closest Maj. Wtr. Body-�%
)f I
)0
-A, 1e....•1.
• I
■■■■■■■■■■■■■■■
■■®■■■■■■�■■■■■■i
Elm
:I:■,IiWo�ZKO:■:MM:::1
ength
imber
rap le
ad/ Riprap length
ngth
- -
■■■■■■�■■■■■■■■�:::■�■■■■■=�■■e
■
■■■■
!�1R1M�!M�'r1l■..��i�nn�ii�■■■
■■�■■■I
■■■■■■■�liiil
i'!�liiii��l�ilii�■■■■®�':1�`r■■■■■■■■■■I
■■■■■■■
■■■■■■■■■1
r■/%■■■■■■■■I
��Emma
■MP
■i■MN
-ME
■■■lll
■
L,■■N\■■�■��i
/•
• • � .� ,
:a■■Cal
��■ri�I■Iril�r!■■��I
■■f�f■■■■■IZINJ■■E�!'J■■h►A■■■'
■■_�
�■__■
■■ap—M
i_■■i_■_
r/■N■■■1
!=-
r■■jeLen
:1:
a�i+l�■■iiii�ili���■�■�I�
__■■_■I
r■�I■I�a������■■■�
■■■■■■■■■■��■■�
■■■■■■■■■■■■li
. �■■
■■■■■■■■■■■■■■i■■■■■■■■®■■E
'M
�:
■
cY
■■■■1:usifid
:::■■■OM■
■II

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: /O 19,;ue W
Phone Number:
Email Address:
1 certify that I have authorized Z�r
�Ag nt /Contra
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 1/0 - --7551e
in 9r4-)NSUJ;c:.e-- County.
r
k� /'�t a -m-ell�
/9
1 furthermore certify that 1 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
Joiwj k'o o'5 -f--
Print or Type Name
Title

in Foust floating dock,ramp,and repairs
�ssage
<[e-mail]> Mon, Apr 24, 2017 at 11:
[e-mail]
is email will serve as my signed none objection to the subject job which adjacent to my property at 39 Isle Plaza
:ean Isle Beach NC. Today's date is April 24, 2017.
Ine R Anderson
04 Wind Bluff Circle
Imington NC.28409
y home phone is 910 784 1601
Complete items 1, 2, and 3. A. Signature
Print your name and address on the reverse ❑ Agent
so that we can return the card to you. X �� ❑ Addressee
Attach this card to the back of the mailpiece, /B ;Received by (Printed Name) C. Date of Delivery
or on the front if space permits. C�--r-We —%%
Article Addressed to: D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
;ene R. Anderson ET Gaye W
804 Wind Bluff Cir.
Jilmington, NC 28409
3. Service Type
❑ Priority Mail Express®
❑ Adult Signature
❑ Registered Mail"R
I III
❑Adult Signature Restricted Delivery
❑Registered Mail Restricted
❑ Certified Mail®
Delivery
5
❑ Certified Mail Restricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
Merchandise
dktRC1lNygt r 00 rom Qe lat,;gt)
❑ Collect on Delivery Restricted Delivery
❑Signature ConfirmationTM
^* �` "^
j'}f3470
O Insured Mail
❑ Insured Mail Restricted Delivery
❑ Signature Confirmation
Restricted Delivery
e
(over 3500)
Y OF rm" , UJ 15 PSN 751Q-02400-9053
Domestic Return Receipt
■ 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.
A. Signatu
Q Agent
— El Addressee
B. Re y (Printed Name) C. Date of Delivery
1. Article Addressed to:
Sharon S Gallimore ETVIR
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No