76447D - Camey

iCAMA/ ❑DREDGE & FILL ' U rt1 ItL SA%allo. 76447 A B
JENERAL PERMIT Previous permit#
;New, Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued /
ized by the State of North Carolina, Department of Environmental Quality —7I l • ZS00
:oastal Resources Commission in an area of environmental concern pursuant to ISA NCAC
Q r/ G
❑Rules,attached.
t Name t`e}d "A Project Location: County r a►r\Sw �c�
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e ,o r h beck try-+ Street Address/State Road/Lot#(s)
aalel9k State ivC ZIP 2-761y 1 t II � " (-'c" .1--
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edAgent -3-oe.\ Via S City dOideli eeial ZIP 2-8114.4
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�,: �EW PTA �S ❑PTS Phone# (�� River Basin L L
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body Lretv 0(r k�'�� (nat-
❑PWS:
yes / no PNA yes / Closest Maj.Wtr. Body A'Wt"J
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ngth 1 IM _La ._
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d/Riprap length 1- `aiiiiiiiill 1 _o kill
distance offshore �—■�I.� _ ���IM_ �7 I /.m'
ix distance offshor ■�'nj�.:vli ��� !1 � ■L�{1111111
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not sure yes eil._................1 -1-e.p ` - .�. ��� __..
um: & yes no , 5 + S
yes
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4ttached: yes
ng permit may be required by: /0 I ' /(4/"N ❑See note on back regarding River Basin r
1oral Planning Iurisdictionl i A .i-% /, 0 ?

AGENT AILTHORIZAT1ON FQ CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Caipey 13gid __-
Mailing Address- 2044 Hornbeck C t
Raleigh, NC 27614
Phone Number:
Email Address: carnet'@aiumni duke ed.i I certify that I have authorized Joel Klass
Agent I contractof
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: repair pier due to storm damage
at my property located at Skimmer Ct Holden Beach
in Brunswick County.
1 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 Owner Information:
(L0t,0-
Siiature
Print or Type Name
- Title
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Date.

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