52457D - Mann

ICAMA/ ❑DREDGE & FILL
3EN ERAL PERMIT Previous permit#
'New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
prized by the State of North Carolina,Department of Environment and Natural Resources II II
:coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC N. 01SCL
r Rules attached.
It it Name - I CA U r4 Pi 4 n YL Project Location: County N Q w ----it Y1 CN-T r
0'3 ,AI/vvi-vvtdii bviv. Street Address/State Road/Lot#(s)
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k(3 51 o-Da 0 Fax#( ,){- _ Subdivision 11i�17 CAI lki- \Su(11(
red Agent IA' ACtitc(�C1-, City�IImor1_ /t i J ZIP 2 L
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ing permit may be required by: N 4,(0 &NT r Co . n See note on back regarding River Basin i
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v • 4• ZUU6 I : 24PM 1 1/03/21308 15!59 N . 3909P.OP . 301
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Mkhmel F, Easley,Govpmor James H.Gregson,Director Maim G.Ross Jr.,Secretary
Date 11 /31 -00$
Name of Property Owner Applying for Permit:
'52\‘'G CIC fr-nanc-
Mailing Address: rrILk,r)tm, Co n C o5 5e ribe.%<=} (ss co
Set 1
C a c-te s r a 'n C ;- Z (4 0
•
I certify that I have authorized(agent)A XI bco -ens C r SA-• _to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permit, necessary to
instal/or construct(activity) rn o v n Q r t ,
at(my property located at)! C„ r1 A ov.1.1 g S1a n
This certification is valid thru (date) l a a o 1 - .
1/
Property Owner Signature Date