76995A_Carpenter, David & Elizabeth_20200728

,I'CAMA / DREDGE & FILL
�. GPENERAL PERMIT Previous permit # B c D
/New Modification ----Complete Reissue -Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 7 . asc'r ot
Applicant Named d 4 �1; Zc1il i1` _�pY�tr
Address-_ 2(>I AN., JooO_
City Clgsapto kt Stated_ ZIP;X l
Phone # ( ) E-Mail
Authorized Agent r, Mar
/C�i
Affected CJ CW �A i❑ P S
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ WA
7 PWS:
ORW: yes / no PNA yes /
Project Location: County_;
Street Address/ State Road/ Lot #(s)J_&;,
t itl_--
Subdivision
City- -- -- — - --- — ZIP%�'---- ----
Phone # (- __-) River Basin %f`Lr- l; --_
Adj. Wtr. Body( jr-!& =_qCdLJ__---_ unkn)
Closest Maj. Wtr. Body -�> i c•oK----_----------------------
Type of Project/ Activity
+ ti h r� P� `r
t,� 16 K l i t Pbf
{z;r�►
(Scale:
Pier (dock) length
Fixed Platforms)
-t;J
Floating Platform(s)
Finger pier(s)_
�" AJ
Groin length
- K
_
numberAll
u khea iprap length J
Ql
avg distance offshore -
max distance offshore
Basin, channel
cubic yards.--- --
- -
3
Boat ramp - -- —
-- r✓ 'ZGd . wlJ.-
Boathouse/ Boatlift
Beach Bulldozing
�, _
Shoreline Length_'1Y3_ _._---- !L �.. .
SAV: not sure yes
Moratorium: n/a no y `'
Photos: no U
Waiver Attached: yes r
A building permit may be required by: f,-t i c k. ai=c -4 r_l See note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions 0j 14Lc r Pk_Hort., ,,, be Ivy,: s�_tte fau%st�i ! e o% fa, 11 f 1,
Agent of Appli inted N e P Officer's Pjinted Name
Signat Please read compliance statement on back of permit's* Signature

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Dav#(d
Mailing Address: l 00 lI
�b
4Vdle-o
n.L
Phone Number: l �% t-f a� "
D 0 Lj
Email Address: `1 M
I certify that I have authorized 1--Ltv�Glt°r� l/h�1/'in
e 1;►%C ,
Agent / Contractor
to act on my behalf, for the purpose of applying for
and obtaining all CAMA permits
necessary for the following proposed development:
-TO C b,-, ,t,`t/ i t G f t s o L4 N-'g
r e &n e4. 4 &ldk /�c qll
at my propertv located at O �vw/G YV
in Cyrl-, 4"( k County.
/ furthermore certify that l 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:
Sr Mu
re
or Tye Name
n Title
a
Date
This certification is valid through 6/ )c)- / C>0

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