49257D - Gilmore

ICAMA/ ❑DREDGE & FILL
3�FNERAL PERMIT Previous permit#
1 ew ❑Modification -- Complete Reissue Partial Reissue Date previous permit issued
-ized by the State of North Carolina, Department of Environment and Natural Resources r
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC P r 1ZOQ
❑Rules attached.
t Name MA✓f t, 6).I vtio V v Project Location: County 04,1/ / .,a v,-
I a I geAC A Rd. $psi 7Y, Street Address/State Road/ Lot#(s)
i/1'l►4ii IP), State Ne ZIP 21y- // ' 4.,
(Ala) 6,20.gSos Fax#( ) <— Subdivision r-, B' sS .
ed Agent AAA,-t: C(C PT-ilvt't5 City �i.t.•re ZIP S -1
❑CW DEW 614A ❑ES ❑PTS Phone# ( -) 544044 River Basin C�is,,,
❑OEA HHF ElIH ❑UBA ❑N/A Adj.Wtr. Body � L - e / (naJt'"Jr
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Clements Marine Construction 8663
910 270-9110 Neec 4356789
577 JVe-Jf1ghway 210 W $%�o`� ss-3ois3,
Armpstead,,Ne 28443 Date 365
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Clements Marine Construction
NCDENR Letter of authorization of Agent
This letter is to grant permission for Mark Clements, DBA, Clements Marine
Construction to apply for, and obtain permits, and all information needed on my behalf
for projects,building permits,NCDENR permits,or any permits required from the State
or Counties in which work will be performed for me.
X I do understand that by allowing Mr. Clements to obtain such permits that this will in
no way release me of any responsibilities to codes, or environmental required permits.
6;./.t.Di c- date G 2 r °7
Print name
sJ — -- date g • 1- - ° 7
Si attire
334- 73,3-0-74 !�w) 3 36• qt /- y1-_! (',•..�
Contact numbers