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Home My WebLink About61610D - WhiteCAMA / DREDGE & FILL C ."3 E N E PAL PERMIT Previous permit # New Modification Complete Reissue El Partial Reissue Date previous permit issued rized by the State of North Carolina, Department of Environment and Natural Resources -oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC - - ❑ Rules attached. t Namely r • ��"' Project Location: County jv' i u l ; _ Street Address/ State Road/ Lot #(s) - -- State ZIP ( ) _ Fax # ( ) �d Agent ; y t ._ 1 , d Cw EW PTA ES PTS OEA HHF IH UBA -1 N/A Subdivision Cityt iu(.Ly\ I&A twl CL-' ZIP 1l Phone # ( )� 1- `1 U 5 S RiverBasin U f} Pws Fc Adj. Wtr. Body ,IC� ,�� C'r.1 k (nat yes / no PNA yes //no J Crit.Hab. yes /' nol Closest Maj. Wtr. Body A Project/ Activity (Scale: y= lock) length __._-- length umber ad/ Riprap length vg'aistance offshore lax distance offshore channel JI ling permit may be required by: ��h C� VlJ (�4< j� ( ��((( Ck ❑ See note on back regarding River Basin .LL n 1 .I :1 .ii,i I .... 1 '_c... I ", I—", �1CDENR North Carolina Department of Environment and Natural Resources Division of Coastal Management Dee Beverly Eaves Perdue James H. Gregson Governor Director AGENT AUTHORIZATION FORM \ Date:-iZ Name of Property Owner Applying for Permit: Mame ofAuthorized Agent for this project: Wh i �e Jr 4 a a s Owner's Mailing Address: fox % e Phone Number (336) Agent's Mailing Address: Phone Number AL 1 So qs I certify that I have authorised the agent listed above to act on my behalf, for the purpose of applying to install or construct the following (activity): for and obtaining all CAMA Permits necessary (my property located) at Z This certification is valid thru (date) n�+o c\ u\ 2cc \�c ZQct scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement ind in your Habitat code sheet. Atat Name DISTURB TYPE Choose One TOTAL Sq. Ft (Applied for. Disturbance total includes any anticipated restoration or tempimpacts) IFINALS Ft. (Anticipated final disturbance. Excludes any restoration and/or temp impact amount) TOTAL Feet FINAL Feet (Applied for. (Anticipated final Disturbance disturbance. total includes Excludes any any anticipated restoration and/or restoration or temp impact temp impacts) amount) Dredge ❑ Fill Both ❑ Other ❑ �S S Dredge ❑ Fill ABoth ❑ Other ❑ O Dredge ❑ Fill ❑ Both ElOther V Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill ❑ Both ❑ Other ❑ GRICE CONSTRUCTION OF BRUNSWICK 8928 COUNTY INC 6618 BEACH DR SW BS. 910-579-9095 66-112/531 OCEAN ISLE BEACH, NC 28469-4710 7 _ DATE u \11 its( t yDOLLARS ' BRANCH BANKING AND TRUST COMPANY ANK BBT EIPT.com {],�/� Ll� tilt r^ 4' ►.t-'� --- ---- -NP ■ 'Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. IN 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: A. Signature X v /' ❑ ALL��rNV\ GAVE B. Received by (PHnted Name) I C. Dkq D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: �60 3. Service Type NI'Certified Mail ❑ Express Mail Registered 1Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7009 1680 0000 2205 9816 (Transfer from service la! PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 U.S. Postal Servicer. CE RTIFIED MAIL,., RECEIPT (Domestic Mail Only; No Insurance Coverage Provided) For delivery information visit our website at www.usps.comr Postage $ Certified Fee $3.10 07 Postmark Return Receipt Fee Q.55Here (Endorsement Required) Restricted Delivery Fee 4i1,(J (Endorsement Required) Total Postage & Fees $ Sb.11 04/15/2013 rn .S.... t- - N l -- V---------------------------- roe, or PO30XZ C tcCQ - ----- ------------------------- �-State,ZIP+4PS Form :rr August 2006 USee Reverse for Instructions Postal MAILW RECEIPT (DomesticProvided) ra �oFor delivery information visit our website at www.usps.com m j u'I C3 W.48 0472 Postage $ ru Certified Fee 10 Q 7 1:3 p Return Receipt Fee Postmark Here $''?.55 C] (Endorsement Required) O Restricted Delivery Fee O (Endorsement Required)CID ytf•IJI) Total Postage & Fees $ $6.11 04115/NO r-R Se o C3 Sheet; An . ao� ............ . ......................... , or PO Box No. EW n D Ce --- ------ -------------------- r �te, +v� 1� PS Fornr :rr August 2006 Z�31U See Reverse tor Instructil P ■'Complete items 1, 2, and 3. Also complete A. Si nnatur item 4 if Restricted Delivery Is desired. �i ❑ Agent ■ Print your name and address on the reverse X ' ❑ Addressee so that we can return the card to you. B. Rec ive by P ' t Nam) T ate of Delivery ■ Attach this card to the back of the mailpiece, / or on the front if space permits. D. Is delivery address different from Item 1? 0 Yes