76469D - Denlinger

1 r A. .
iCCAMA/ IIIDREDGE & FILL t i NO 76469 A B
MNERAL PERMIT _ -- Previous permit#
INew ❑Modification El Complete Reissue III Partial Reissue Date previous permit issued
•ized by the State of North Carolina, Department of Environmental Quality
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 0144 .25°tom
Rules attached.
t Name C' (l S e✓A,n i ,- Project Location: County (11,,..,,,,--N.S...... ctA--
OP2J-(1Q eve vq Ilr� Se et Street Address/State Road/Lot#(s)
2Ae`t / i i1State i$CZI P--1-(e(y \3o-inckcl2. C4'_
(9(1) [a(2 002Z E-Mail QOSkh\)eCL, Subdivision
ed Agent -c(� Li< 4City OCt \.s4 C)e .c t, ZIP - `tI
❑EW &TA ❑ES ❑PTS Phone# ( ) River Basin Lam►A.
O EA ❑HHF (❑IH 0 UBA ❑WA ,,^\S Cb"-ce-(L
Adj.Wtr. Body /i
❑ PWS:
yes / 71 PNA yes /e52 Closest Maj.Wtr. Body NA'•"`� 0C-'
Project/Activity ",vl G to,)6((,,... �� , ,, 1., .., ( (._, yi, , ,)(._ c.¢. ( ... ...(
\\kv)s c J Ou c� t ,r - -hAq•, ni-. (Scale:v I
:k)length
I
itform(s)I0'1/U' 1
Platform(s) YI —t__,\I__ __ f
ier(s) n Ic.A-
igth ,
I 1 y` i
f prap length 50 _._.
distance offshore 8' ; I
x distance offshore I
ca i
cannel . 1
sic yards
.p �uT
I s
se/Boatlift —_..._..t_ : —_ -._... —
{ 6 Vim" eukl�+ �� y c.u �' ` K ,`•
illdozingj
j
I I ~Qt U �kr\�`5 6� La
Il L
,
Length ti 5 c0' x (j.or �•„r
not sure yes o 4 t j
cum: n a yes ^1 Q .�.... ..._......... 9h--y
/ 1- I -..,?(..—
es
\ttached: yes n I
ig permit may be required by: O(ELA.. (,c(i-- ( e,•r tn . U See note on back regarding River Basin n
Local Planning Jurisdiction) .__

AGENT AUTHORIZATION FOR CAMA PERMIT APPUCATION
Name of Property Owner Requesting Permit CifIr S tJ�Y1�iY��P�Y
Mailing Address: 103 j(, Eu rgre_e K. sp rv0\ ?L
ZQle,ioJk, , t c 2-NM- r62
Phone Number: 91 q " 6 LZ - DU2Zn-
Email Address: P ' WC4-ivt �Sl"" � . �r'l.
I certify that I have authorized TIt/- 1fitAW6K5
Agent 1 Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development Ska✓n1 hCeO.:.r.
at my property located at 5 e)0 r'nctt,e
in ? U WIZ/ -county.
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
permit application.
Property Ownerprformation:
L/
�1$ignatt'tS (//�Qn �
e • / �, d don OC+►
ire
Print or Type Name)
\ �"
Title ,,
A___JZ / v\ 4" 1 S t
This certification is valid through lJ —t—r►AA T li S bv'j-7r' -