76551D - Greer

�CAMA / ❑ DREDGE & FILL N9 76551 A B
"ENERAL PERMIT Previous permit #
ONew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
sized by the State of North Carolina, Department of Environmental Quality 7 41 �zG
Zoastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules�ched.
it Name PAJ � Project Location: County '64
!(J-! �-.
State ZIP
t ) 7/ -�` - 6704-Mail
:edAgent 6/e *LA aw
❑ CW -7EW IH A ❑ ES 1-1PTS
❑ OEA b HHF ❑ URA ❑ N/A
❑ PWS:
yes / no PNA yes / no
f Project/ Activity
)ck) length_
latform(s) _
Platform(s)
Ld/ Rikap length_
g distan a offshore
ax distanc \ shore
hannel
ibic yards_
mp
ise/ Boatlift
ie Length f / 10
not sure yes
rium: n/a yes
yes
Attached: yes
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP ��
Phone # —� -�- River Basin
Adj. Wtr. Body 1 1 / N / nat
Closest Maj. Wtr. Body
(Scale: /
ing permit may be required by: / ew a& 6o, ❑ See note on back regarding River Basin r
Local Plannin¢ lurisdiction)

�3soc�o%/ / 33.E CJ /,'r��,

AGENT AUTHORIZATION FOR CAMA PERMIT APPUCATtON
�)
Name of Property Owner Requesting Permit: � ^:
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
Agent / Cmtmdar
v�-
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development. - �� �?[.-
GcJ;
i t zW
at my property located at
in )LOAI-I County.
l 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
Print or Type Name
Title

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
t hereby certify that 1 own property adjacent to '. 6 s
// (Name of Property Owner)
property located at
Address, Lot, Block, Road, etc.)
on �l ���, c� �� / jj
in /TN�f/r-� �C / fr�✓f [/ , N.C.
( erbody) (T wn and/or County)
He has described to me as shown in the attached application and project drawing(s), the development he is
proposing at that location, and. I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature
Print or Type Name
G1IU s-1-t9-270<�
Telephone Number
14���i/
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to %s �i✓ �na< is
(Name of Property Owner)
property located at 1�9 � P>,�l�� / 6; FA
Address, Lot, ock, Road, etc.)
on r'i1 rtc.Ci in N.C.
( erbody) (T n and/or County)
He has described to me as shown in the attached application and project drawing(s), the development he is
proposing at that location, and. I have no objections to his proposal.
Ac k4i J. Lit .
Print or Type Name
t 12- SS'( 7-?3a
Telephone Number
��
Date

12111M nwwy��
rA�an■
Done
MaQ_Bk?9_Pp129 (2 of 3)
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2C♦ AC /
MMON AREA
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0751 AC
0.739
At.
8
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0 954 Ac.

Oftwd
IVaaM o/FiWisW /Deldar
V ndy
Check Number
Ch-k
rnmrf
Prrrnit Numbw/C—nts
RwWpt or Rorund/RNllocand
88
Coh-4
Cell
Columns
C.01-7
Column8
Columna
in
same
same
Suntrust
_ 6508
8987
200.00
GPt76508D
Go0765070 _
JDret.10229
JD rot 10230 -------- -
FCB
$ 200.00
_ _
Andy Darden - - Coastal Bank and Trust
'Suzanne whitmever Branch Banking atM Tnnt
Michael Yacopino FCB
same uMB Bank
Dawn Greer FCB-
lAnn Rose Coastal Bank and Trust
_
3113
600.00
GP /765=
JD rCt 10231
36773
S 200.00
GP #7&118D
Ban rd. 10440
1081
600.00
GP1175815D
inrol10447
111
1 200.00
GPs764o2D
Ban rct 10445
21741
5 200.00
I GP#76551D
I JD rnL 10233