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HomeMy WebLinkAbout14-03D B&B Marine Construction LLCn AG"A RESEW North Carolina Department of Environment and Natural Resources Pat McCrory, Division of Coastal Management Governor June 25, 2014 B & B Marine Construction, LLC c/o Mr. Brandon Grimes P.O. Box 2574 Surf City, NC 28445 John E. Skvarla, III Secretary RE: Closure Letter Payment of Proposed Penalty for Violations of the Coastal Area Management Act, Committed in Pender County CAMA Violation #14-03D Dear Mr. Grimes: This letter will acknowledge receipt of your Money Order #1139200122, in the amount of $497.00, dated June 18, 2014 ($47.00 overpayment applied to GP 63955D). Once the amount is credited to the Department of Environment and Natural Resources' account, this matter will be fully and completely closed. Thank you for your cooperation in resolving this violation. If you have any further questions concerning this matter, please contact me at the Wilmington Regional Office, (910) 796-7215. Sincerely, Debra D. Wilson District Manager DDW/ph cc: Roy Brownlow, Compliance Coordinator WIRO File Copy 127 Cardinal Drive Ext., Wilmington, NC 28405 Phone: 910-796-7215 \ FAX: 910-395-3964 Internet: www.nccoastalmaiiagement.net rn RECEWED N 3 0 CM-MBD crrn An Enuat Opportunity 1 Affirmative Action Employer DCM ENFORCEMENT TRACKING REPORT WLPJComp j 4 ALPO �P_ y, Violation Descripl Initial Discovery Date Violation [�escnption 4 I\. .t ( Respondent Name(s) Address Phone # Issuer `� 4Rep.� �, ❑Violation Case No.E3�PermltNo.(if applicable) M Prior CAMA or D/F Itiq Yes / N PriorCase City.,....,:.,.,..._...._�.�. Fax #/Email _ State Zip Violation Type: Project Type: Authorizations Required: Site Visits Respondent Site Visits Respondent Present Present ❑ No Permit � Private/Community � Major � CAMA I . Permit Condition ❑ Govt./Public ❑ minor ❑ D&F a O ❑ Expired Permit ❑ Commercial neral 0 ❑ j�Inconsistent w/ Rules ( 6 ❑ T� Tier Level: I II III Violation Location and Site Description Project Location: County Street Address/ State Road/ Lot #(a) Subdivision City V V ZIP_ Phone # -o) aver Basin Adj. Wtr. Body Closest Maj. Wtr. Body ,1\, NOV Date Initial Req. Comp. Date CNOV Date (Q .25 . + y Date Comp. Observed Penalty Assessment Sent to Respondent Date —` 'O" 1 • �'" App./Permit Fee Rcvd. by Dist. Mgr. Date Penalty Assessment Extended Yes No WillfuUlntent. RECEIVM Continuing Investigative h JUN 30 2014 Lat/Long Shoreline Length SAV: Not Sure Yes Sandbags: Not Sure Yes PNA: Yes Adjacent ORW: Yes No Adjacent Crlt. Hab. Yes No 11 Photos Waiver Required Yes In DWQ Buffer Area Yes No Specify DWQ Buffer if applicable: Extension Granted L Restoration Letter N y'� in a„ Atr Pd�1 Yes No 7J.0409 Ref. Recomm. Assess. DCM Assess. $ ' 1J $ $ �� $ is is Tolal 145T -- DCM-MHD CPPY Formal Assessments, Appeals and Reductions Date Long Form Submitted Assessment Appealed: 1'es No Date Formal CPA Submitted Final Assessment$ Date Q Penalty modified Attorney General's Office for Injunction or Formal Collection Date sent to AG Respondent not responsive to penalty/NOV Injunction to complete restoration Date Collection Letter Sent Date Demand Letter Sent Violation Activities and Impacts AECs Affected: �� Wetlands Impacted? Yes No If yes, which types: CW (EW PTA ES PTS OEA iiRF UBA NIA SA DS CJ SY JR LS TY PWS: FC: SS SC SP IF BF 404Cb All � j� V rV i Other: J Restoration Required by the Respondent Dimensions in excess of permit/ unauthorized activities Dimensions to restore Final allow d Actually y restored kbetlorienAFdv .ate - NOTES: Closing Payment Received $ Date Date Case Closed 4 OWN North Carolina Department of Environment and Natural Resources Pat McCrory John E. Skvada, III Governor Secretary April 29, 2104 CERTIFIED MAIL 70110110 0000 9947 2512 RETURN RECEIPT REQUESTED B & B Marine Construction, LLC c/o Mr. Brandon Grimes P.O. Box 2574 Surf City, NC 28445 RE: CAMA VIOLATION # 14-03D Dear Mr. Grimes: RECEIVED MAY 6 2014 DC:ve%"D C:Ty This letter is in reference to the Notice of Violation dated March 14, 2014 that Tara MacPherson, representative for the Division of Coastal Management, issued to B & B Marine Construction, LLC for violation of CAMA Major Development Permit No. 62542D, which was issued for development on property owned by Ms. Catherine Kelly located at 501 South Topsail Road, Pender County. The violation involved Estuarine Waters and Public Trust Areas, which are Areas of Environmental Concern designated by the Coastal Resources Commission. The Coastal Area Management Act provides that a civil assessment of up to $10,000 plus investigative costs may be assessed for any violation. It is the policy of the Coastal Resources Commission to assess a civil penalty for all violations in order to recover some of the costs of investigating violations and/or to compensate the public for any damage to its natural resources. Under the rules of the Coastal Resources Commission, a proposed civil penalty in the amount of $450 is appropriate for this violation. You may expeditiously resolve this matter prior to the assessment of a formal civil penalty by accepting responsibility for the violation and paying the amount proposed above. In order to do this, you must: (1) sign one of the attached copies of an "Agreement to Pay Civil Assessment;" (2) attach a check or money order for $450 made payable to the North Carolina Department of Environment and Natural Resources (NCDENR); and, (3) return the signed agreement and payment to this office in the enclosed, self-addressed envelope within ten (10) days of your receipt of this letter. Upon deposit of your check in the Department's account, you will receive a Notice of Compliance officially closing this enforcement action. If you do not send a signed agreement and payment to this office within ten (10) days, the Director of the Division of Coastal Management will formally assess a civil penalty against B & B Marine Construction, LLC. You will then have the opportunity to request a hearing on the penalty or request settlement of the penalty. 127 Cardinal Drive Ext., Wilmington, North Carolina 284053645 Phone: 910-796-72151 FAX: 910-39539641 Internet: www.ncooastalmanagement.net An Equal opportunity 1 Affirmative Action Employer- 50% Recycled 110%" Post Consumer Paper B & B Marine Construction, LLC April 29, 2014 Page 2 Thank you for your time and cooperation in resolving this important matter. If you have any questions, please do not hesitate to contact me at (910) 796-7266. Sincerely, Debra Wilson District Manager Enclosure TmIDw cc: Roy Brownlow, Compliance Coordinator, DCM Jason Dail, Coastal Management Representative, DCM rMRECEIVED AY 6 2014 DCM-MHD CTTV 127 Cardinal Drive 6d., Wilmington, North Carolina 294053845 Phone: 910-796-7215 \ FAX: 9103953964 \ Internet: www.nocoastaimanagement.net An Equal Opportunity \ Affirmative Action Employer— 50% Recycled \ 10% Post Consumer Paper B & B Marine Construction, LLC April 29, 2014 Page 3 CAMA VIOLATION #14.03D B & B Marine Construction, LLC AGREEMENT TO PAY PROPOSED CIVIL ASSESSMENT I understand that the staff of the Department of Environment and Natural Resources will propose the assessment of a civil penalty in the amount of $450 against B & B Marine Construction, LLC for violation of the Coastal Area Management Act, NCGS 113A-100 et sec, committed on or near property located at 501 South Topsail Road in Pender County, North Carolina. In order to resolve this matter with no further action or expense on my part, I accept responsibility for the violation, on behalf of B & B Marine Construction, LLC, as described in the Notice of Violation letter dated March 14, 2014, and agree to pay the proposed civil assessment of $450. DATE SIGNATURE ADDRESS TELEPHONE NUMBER rnRECEnD AY 6 2014 CM-MHDC17y 127 Cardinal Drive Ext., Wilmington, North Carolina 284053845 Phone: 910-796-72151FAX: 91039"96411ntemel: www,nocoastalmanagement.net An Equal Opportunity 1 Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper CM ENFORCEMENT TRACKING REPORT Rep. Violation Descripi �f Initial Discovery Date Violation Description IssuuJer Violation Case No. Permit Na. El (if applicable) or D/F Vigl4tion$,; Yes / RespondentName(s) Y\I\,V lV\1C `l_.Il`V3r0A"UYI t IV �,V LanaowneriAgenu ono Address. City ,,, ,_a State__ Zip Violation Type: Project Type: Authorizations Required: No Permit Private/Community Major CAMA Permit Condition �� Govt./Public Minor C: D&F Expired Permit El Commercial neral ' Inconsistent w/ Rules Tier Level: I C II III Violation Location and Site Description Project Location: County Street Address/ State Road/ Lot City.. \I� V i \ Phone # Its Adj. Wtr. Body Closest Maj. Win Body NOV Date V 0 Initial Req. Comp. Date CNOV Date Date Comp. Observed Penalty Assessment Sent to Respondent Date 'O l L Ee Permit Feelty Rovd. by Dist. Mgr. Date illfuVintent. Assessment Extended Yes No W Continuing Site Visits Respondent Site Visits Respondent `I Present Prees-yent Lat/Long .. Shoreline Lengthur SAV: Not Sure Yes Sandbags: Not Sure Yes N PNA: Yes N Adjacent ORW: Yes NoAdjacent Cdt. Hab. Yes No Photos es Waiver Required Yes In DWQ Buffer Area Yes No Specify DWQ Buffer if applicable: Extension Granted l VI� Restoration Lister _ 'AaA fl., . A?Jepll rUe Pj Yes No 7J.040g Ref. Recomm. Assess. DCM Assess. $ $ $ Is $ Total 1 ,5Z Formal Assessments, Appeals and Reductions Date Long Form Submitted Assessment Appealed: 1(es No Date Formal CPA Submitted Final Assessment$, Date Attorney General's Office for Injunction or Formal Collection Q Penaltymodified Date sent to AG Respondent not responsive to penalty/NOV `Q Injunction to complete restoration, Date Collection Letter Sent Date Demand Letter Sent Violation Activities and Impacts AECs Affected: ���� Wetlands Impacted? Yes No If yes, which types: CW (EW/ PTA ES PTS OFA RRFF�� USA N/A SA DS CJ SY JR LS TY n PINS Fc: SS Sc SP IF BF 414 Other: �',j, (fly_ �IIXn— Restoration Required by the Respondent Yes / No VA Dimensions in excess of permitt unauthorized activities Dimensions to restore Final '- allow d Actually restored .,stMM `.rh i �s �- `ii` NOTES: Closing Payment Received$ Date Date Case Closed DCM ENFORCEMENT TRACKING REPORT 1 Issuer Violation Case No. IF,iem'dPRep. 1 Eloliance Ike 0 J Permit No. (if applicable) Violation Description J Was Initial Discovery Date ` Discovery M ho`(d- Violation Qescription 'n `p( .1(`MVA. or D/F YtplAGon&Yes / Nq , Prior Case Respondent Name(s) J rr_VA�ILysY "[.Il`V.Vlk_V Al�„_Yl \ Iv%,YVW 2(Lanaownenngenv-om Address City .,....., _ ,..�� State_ Zip Violation Type: Project Type: Authorizations Required: SRe Visits Respondent Site Visits Respondent D: No PermitPrivate/Community Major � CAMA Present Present ( Permit Condition Govt./Public Minor -C. D&F171 a' 0 Expired Permit 13. Commercial General 0 ( D jc�Inconsistent w/ Rules Tier Level: ( II III Violation Location and Site Description LaULong Project Location: County Shoreline Length. / Street Address/ State Road/ Lot #(a) , SAM Not sure ves Sandbags: Not Sure Yes PNA: Yes Adjacent Subdivision ORW: Yes No Adjacent City � .ZIP./Ll q Crit. Hab. Yes No Phone# Iu ). River Basin Photos ®yyyyyyyy''-0000---,,.,1 Adj. Wtr. Body n /man nkn Waiver Required Yes ' In DWQ Buffer Area Yes No Closest Maj. Wtr. Body Specify DWQ Buller R applicable: NOV Date ✓ -\?- L CNOV Date Penalty Assessment Sent to Respondent Date Rcvd. by Dist. Mgr. Date Assessment Extended Yes RECEIVED MAR 18 2014 Initial Req. Comp. Date q • 1i• 1'1 Date Comp. Observed App./Permit Fee Penally WiIlfuUlntent. No Continuing Extension Granted Yes No Restoration Letter Acceptance Date 7J.0409 Ref. Recomm. Assess. DCM Assess. $ $ $ $ $ Is Total I DCM-Mw CITY Formal Assessments, Appeals and Reductions Date Long Form Submitted - Assessment Appealed: Yes No Date Formal CPA Submitted Penalty modified Final Assessment. $ Date Attorney General's Office for Injunction or Formal Collection Date sent to AG Respondent not responsive to penalty/NOV ❑ Injunction to complete restoration Date Collection Letter Sent Date Demand Letter Sent Violation Activities and Impacts AECs Affected: Wetlands Impacted? Yes No If yes, which types: CW EW PTA ES PTS OFA URA N/A SS SC SP IF BF 404 TY PWS: FC: (� J Other: � � /yjl Restoration Required by the Respondent Yes No / Jtf�/�' Dimensions in excess of permit/ unauthorized activities Dimensions to restore Final allow Actually restored Development Activities Habitat Description - NOTES Closing Payment Received $ Date Date Case Closed North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis John E. Skvarla, III Governor Director Secretary NOTICE OF VIOLATION March 14, 2014 CERTIFIED MAIL 70110110 0000 9947 2437 RETURN RECEIPT REQUESTED B & B Marine Construction, LLC RECB= c/o Mr. Brandon Grimes P.O. Box 2574 Surf City, NC 28445 MAR 18 2014 RE: VIOLATION(S) OF CAMA MAJOR DEVELOPMENT PERMIT NO. 62542D* CAMA VIOLATION #14-03D DCMM'M MC f y Dear Mr. Grimes This letter is in reference to my February 14, 2014 site visit at property owned by Ms. Catherine Kelly Topsail Sound located in Surf City located at 501 South Topsail Road, Pender County, North Caroline of the onsite visit was to investigate unauthorized development on the aforementioned propertv references the site visit conducted on January 28, 2014 and March 11, 2014 by Jason Dail, F and your subsequent conversation regarding unauthorized development at this location. Information gathered by me for the NC Division of Coastal Management indicates that tb Construction, LLC as contractor for Ms. Catherine Kelly are in violation of the terms P, Development Permit No. 62542D which was issued to B & B Marine Construction.' Commission and the North Carolina Department of Environment and Natural W immediately CEASE AND DESIST such violation(s) and comply with the tern the terms and conditions of a permit are not complied with, the permit is P On October 24, 2013, CAMA Major Development Permit No. 62542r LLC on behalf of Ms. Kelly for of a pier and 400 sq. ft. platform ae Pender County, North Carolina. This permit was issued for try' Trust Areas, Areas of Environmental Concern (AEC), in as 113A-118. This permit included the following terms and conditio, 1. All construction shall comply with 15A For the following reasons, you are in violaL. 1. According to 15A NCAC 07H .1205(e):1 pier) allowed shall be 8 sq. ft. per linear fo,, platform (400 sq. ft.). The 50 ft. shoreline ak 127 Cardinal Drive Ext., Wilmington, North Carolina 28405-3845 Phone: (910) 796-721S FAX: 910395-39641 Internet: www.nccoaslalmanaga An Equal Opportunity 1 Affirmative Action Employer— 50% Recycled I10% Post Cons, B & B Marine Construction, LLC March 14, 2014 Page 2 of 2 additional unauthorized 5 ft. by 21 ft. platform (105 sq. ft.) was constructed creating 505 sq. platform. I request that you immediately CEASE AND DESIST any further development and contact me about this matter. A civil assessment of up to $10,000 plus investigative costs may be assessed against any violator. Each day that the development described in this Notice is continued or repeated may constitute a separate violation that is subject to an additional assessment of $10,000. An injunction or criminal penalty may also be sought to enforce any violation in accordance with N.C.G.S. 113A-1 26. It is the policy of the Coastal Resources Commission to levy a civil assessment not to exceed $10,000 plus investigative costs against all violations. This is done to recoup some of the costs of investigating violations and/or to compensate the public for any damage to its natural resources. Whether a higher amount will be assessed depends on several factors, including the nature and area of the resources that were affected and the extent of the damage to them. Based upon the North Carolina Administrative Code, Title 15A, Subchapter 7J.0409(g)(4)(E) the policy of the Coastal Resources Commission is to levy a civil assessment against contractors in addition. to that assessed against the landowner. Therefore, you should expect a civil assessment to be levied against you. I request that you contact me immediately about these important matters. The relevant statutes and regulations are available from this office, and I am willing to assist you in complying with the requirements of these laws. A site inspection will be made in the immediate future to determine whether this REQUEST TO CEASE AND DESIST has been complied with. Upon my submission of an enforcement report to the District Manager you will be notified as to the amount of the civil assessment for failure to comply with the terms, conditions, or requiremen Sint Tara MacPherson Coastal Management R se tative Cc: Debra Wilson, District Manager, DCM Roy Brownlow, Compliance Coordinator, DCM Jason Dail, Field Representative/LPO ENCLOSURE REG MAR 1 DC,v 127 Cardinal Drive Ext., Wilmington, North Carolina 284053845 Phone: (910) 796-72151 FAX: 910-39639641 Internet: www.nccoastaimanagement.net An Equal Opportunity 1 Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper i 1 � '� 1 ' V. �i t" _ l^• Ilr. .bf CDEEIR North Carolina Department of Environment and Natural Resources Division of Coastal Management Pat McCrory Braxton C. Davis John E. Skvarla, III Governor Director Secretary NOTICE OF VIOLATION March 14, 2014 CERTIFIED MAIL 70110110 0000 9947 2437 RETURN RECEIPT REQUESTED B & B Marine Construction, LLC c/o Mr. Brandon Grimes xECE1VED P.O. Box 2574 Surf city, NC 28445 MAR 18 2014 RE: VIOLATION(S) OF CAMA MAJOR DEVELOPMENT PERMIT No. 62542D' CAMA VIOLATION#14-03D DC:AM—IfDCITY Dear Mr. Grimes: This letter is in reference to my February 14, 2014 site visit at property owned by Ms. Catherine Kelly, adjacent to Topsail Sound located in Surf City located at 501 South Topsail Road, Pander County, North Carolina. The purpose of the onsite visit was to investigate unauthorized development on the aforementioned property. This letter also references the site visit conducted on January 28, 2014 and March 11, 2014 by Jason Dail, Field Representative, and yoursubsequent conversation regarding unauthorized development at this location. Information gathered by me for the NC Division of Coastal Management indicates that the actions of B & B Marine Construction, LLC as contractor for Ms. Catherine Kelly are in violation of the terms and conditions of CAMA Major Development Permit No. 62542D which was issued to B & B Marine Construction, LLC by the Coastal Resources Commission and the North Carolina Department of Environment and Natural Resources. I hereby request that you immediately CEASE AND DESIST such violation(s) and comply with the terms and conditions of the above permit. If the terms and conditions of a permit are not complied with, the permit is null and void from the date of its issuance. On October 24, 2013, CAMA Major Development Permit No. 62542D was obtained by B & B Marine Construction, LLC on behalf of Ms. Kelly for of a pier and 400 sq. ft. platform adjacent to Topsail Sound on property located in Pender County, North Carolina. This permit was issued for major development in the Estuarine Waters and Public Trust Areas, Areas of Environmental Concern (AEC), in accordance with North Carolina General Statutes (N.C.G.S.) 113A-118. This permit included the following terms and conditions(s): 1. All construction shall comply with 15A NCAC 07H .1200. For the following reasons, you are in violation of the above terms and conditions(s) of said permit: 1. According to 15A NCAC 07H .1205(e): The total square footage of shaded impact for docks (excluding the pier) allowed shall be 8 sq. ft. per linear foot of shoreline. This permit was issued for a 20 ft. by 20 ft. platform (400 sq. ft.). The 50 ft. shoreline allows for a maximum of 400 sq. ft. of shaded impact. An 127 Cardinal Drive Ext., Wilmington, North Carolina 28405-3845 Phone: (910) 796-72151 FAX: 910-395396411ntemst: www.nocoastalmanagement.net An Equal Opportunity \ Affirmative Action Employer — 50% Recycled 110% Past Consumer Paper B & B Marine Construction, LLC March 14, 2014 Page 2 of 2 additional unauthorized 5 ft. by 21 ft. platform (105 sq. ft.) was constructed creating 505 sq. ft. of total platform. I request that you immediately CEASE AND DESIST any further development and contact me about this matter. A civil assessment of up to $10,000 plus investigative costs may be assessed against any violator. Each day that the development described in this Notice is continued or repeated may constitute a separate violation that is subject to an additional assessment of $10,000. An injunction or criminal penalty may also besought to enforce any violation in accordance with N.C.G.S.113A-126. It is the policy of the Coastal Resources Commission to levy a civil assessment not to exceed $10,000 plus investigative costs against all violations. This is done to recoup some of the costs of investigating violations and/or to compensate the public for any damage to its natural resources. Whether a higher amount will be assessed depends on several factors, including the nature and area of the resources that were affected and the extent of the damage to them. Based upon the North Carolina Administrative Code, Title 15A, Subchapter 7J.0409(g)(4)(E) the policy of the Coastal Resources Commission is to levy a civil assessment against contractors in addition, to that assessed against the landowner. Therefore, you should expect a civil assessment to be levied against you. I request that you contact me immediately about these important matters. The relevant statutes and regulations are available from this office, and I am willing to assist you in complying with the requirements of these laws. A site inspection will be made in the immediate future to determine whether this REQUEST TO CEASE AND DESIST has been complied with. Upon my submission of an enforcement report to the District Manager you will be notified as to the amount of the civil assessment for failure to comply with the terms, conditions, or requirements of such permit. Sind Tara MacPherson Coastal Management &se Cc: Debra Wilson, District Manager, DCM Roy Brownlow, Compliance Coordinator, DCM Jason Dail, Field Representative/LPO ENCLOSURE rM RECEIVEDAR 18 2014 DC-14-M.. D CITY 127 Cardinal Drive Ext., Wilmington, North Carolina 28405-3845 Phone: (910) 796-72151 FAX: 910-395-396411ntemet: www.n000astalmanagement.net An Equal Opportunity 1 Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper C/kr0(7C7 ❑ DtiE®CaE &FILL' ' ` M1 X. : ENERAL PERMIT Previous permit # New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued " As authorized by the State of North Carolina, Department of Environment and Natural Resources and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / Applicant Name` �❑ les a3ached. Project Location: County ; ! ' Address - `. _ Street Address/ State Road/ Lot #(s) City;; —1'- — —State' `� ZIP'' 4-5-','% �f 9 ✓�` d�tTJr',� �h'',rf.' . Phone # (+' )_'. _ Fax # ( ) Subd' 'sion Authorized Agent i i / f r?f' / l' G9G� City '1 rr4 ZIP _ o cw Ey >UPTA p.JEs ❑ PTS Phone # (9�i� ) 5YV •-S 3 River Basin L ,Z Affected AEC(s): OEA ❑ HHF O IH ❑ URA ❑ N/A- Adj. Wtr. Body �u - e' "•'' nat man unkn ORW: P ` Hab. �R '/ Closest Maj. Wtr. Body yes no yes no \Crit yes km' Type of Project/ Activity I^ Pier (clock) length to k576 AM ■■■■■■■■!■■■■■il■■■■! Finger pler(s) caaa�� F ■■■■■IrIJ■■■■■■fi■■■■■■ number iiiiiiiiiiiiii��iwis�'��isr�l■iiiiiiiiii ■■!■■■■■■■■■■■■■■■■�����!■�*:�a■■%■!Ills■■■■■■■ ■■■■■■■■■■■■■■■■■■■■►att!■■�r■■■■�■■■■■■■■■ MEN max distance offshore —I Boat rainp _ - .■ill iiiiiiii�iiiiiiMEME moll 00ii MEMENIMEMEMEME ■■■N■■■■■■■■■■■RI■■!■■i■■!!Ili►■■■■■■■■■■■■■ ■■■■■■■!■■■■■■■■Y■■■■■!■■fill■►■■■■■■■!■■■■ III■■■■■■■■■■■■■■■■■■■■■■■t111■■■k A■■■■■■■■■ �a ■; i;fiF7■■■■■■■■■■■■■■■f■■ICi[ti■■1'J■lll�6��;1■■■■■■ 7��5������■�����������F��t�ll����� S■■EN i� IfiiliYi Wi■■■■■■■■■111■■i■■■I■■4■il■■■■■i11\■■!!!■■ ■■■■■■■■■■■■■■■Y■■■■■I■■till■■■■■ll�\■■■■■■ I Agent or,J�)plicant Printed Name Signature•'"Please read compliance statement onback ofpermit ( d�22-> € f 0 . Pj t Issuing Date Application Fee(s) Check# uGCalrl t 1 nature. r ExpimOon Date fiction Roverfile Name -