68557D - Oliver's

CAMA / ❑ DREDGE & FILL `�i� ` 8557 A B
"ENERAL PERMIT Previous permit#
New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources , 7
oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC Off( I I UV F-1 Rules attached.
Name ' -rc. S V ( � 0 C U- C Project Location: County �-t o S 1AA &ch
10 1 �� �_ S�
4-1, <-{-
State_ ZIP
E-Mail
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ad Agent JctJ'
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❑ CW ❑ EW ❑ PTA
ES KPTS
❑ OEA ❑ HHF ❑ IH
❑ UBA ❑ N/A
❑ PWS:
yes 10 PNA yes /
UO
Project/ Activity
ck)length
atform(s)
Platform(s)
,ier(s)
:ngth
tuber
dhRiprap length_
gg distance offshore 0
ax distance offshore Q
hannel
ibic yards
mp
use/ Boatlift
Widozing
kc-r= bW5
+S
Street Address/ State Road/ Lot #(s)
S a w`c
Subdivision
City
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Phone # ( ) River Basin , r `<
Adj. Wtr. Body at
Closest Maj. Wtr. Body Gr p_
ZIP '�—
(Scale: I = 11
❑ See note on back regarding River Basin
r r i

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: QL1\[ 12S
Mailing Address:
%
Phone Number: -7Ut-1- ' Lt) H '-i (d 0
Email Address: S LhN 0) S SFt 7'n:±0'n2T(a� HC ram} I i_ , 0
I certify that I have authorized David Logan of Logan Marine, LLC
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
L ` ",
at my property located at 101 \AJ' % '1
in County.
I 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
456,7Zaop,- - La^d,:s
Print or Type Name
Title

■ 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:
R\v-�C-ILS of l-e lhsxE� IN
cIil, Sam+ yii�Tl AN-rlLA
I t'i4L Z%*1lel
II1111111IIII IIIIIIIII IIII II I1I IIII) IIIII II III
9590 9402 2978 7094 5965 12
2. Article Number (Transfer from service label)
7016 0910 0000 6063
PS Form 3811, July 2015 PSN 7530-02-000-905,
■ 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:
C t-vQl 0-'Ir T
2c51 C�Mom- NL mZ16 ST
A. Signature
B. Received by�Printed Name) I C. I)# of l
D. Is delivery address different from item 1? 1 0 Ye,
If YES, enter delivery address below: ❑ No
-RECEIVED
DCM WILMINGTON, NC
OCT 2 4 2017
3. Service Type
❑ Priority Mail Express®
❑ Adult Signature
❑ Registered MailT
❑ Adult Signature Restricted Delivery
❑ Registered Mail Restricted
El certified Melle
Delivery
❑ Certified Mail Restricted Delivery
❑Return Receipt for
❑ Collect on Delivery
❑ Collect on Delivery Restricted Delivery
Merchandise
❑ Signature Confirmation*"
❑ Insured Mail
❑ Signature Confirmation
8449 la I Restricted Delivery
Restricted Delivery
a
Domestic Return Receipt
❑ Agent
❑ Addressee
41"c v Sri ertj d Nam / Qat of Deli, ry 1�. 1V1
D. Is delivery address different from item 1? 10 Yes
If YES, enter delivery address below: ❑ No
RECEIVED
DCM WILMINGTON, NC
OCT 2 4 2017
3. Service Type
❑ Priority Mall Express@
II
I
Ilill
IIII
II
I II
I II
I II I
I III
II
II I
I I
II III
❑ Aduk Signature
❑Registered MailaiITMT"'
❑ Adult Signature Restricted Delivery
❑ Re�istered Mail Restricted
9590 9402 2978 7094 5965 29
❑ Certified Mail estricted Delivery
❑ Return for
❑ Collect on Delivery
Merchandise
2. Article Number (Transfer from service label)
❑ Collect on Delivery Restricted Delivery
"tail
❑ Signature Confirmation*"'
❑ Signature Confirmation
7 016 0 910 0000 6063
016 0 910
Delivery
8 418 01 Restricted Delivery
8 4187
Restricted
Restricted DeliveryRestricted