73754A-Palmatier

No. 73754
9CAMA /'U DREDGE & FILL
GENERAL PERMIT
®New ❑Modification ❑Complete Reissue ❑Partial Reissue
Previous permit #_
Date previous permit
(A) B C D
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area ofenvironmental concern pursuant to I SA NCAC
fLl RiAve err�.6ed
Applicant Name (Ylc.( 1- A V", 7g6z( -
Address a.o. `�fi 919
City L--I_u r.� State KK ZIP aE315 I
Project Location: County
Street Address/ State Road/ Lot #(s)
t"i'e.less
Phone # ftico) (oil - 51 3L� E-Mail _21hc 1( u a @pc d,r, „Subdivision I-n(,,C I (<we
Authorized Agent _r rc r 4 �c -,1 (� ,ee City �11"0( n S ZIP ] Jy S
Affected 0CW UEW [9PTA . ®ES CR PTS
AEC(s): 71 OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWs:
ORW: yes no PNA yes knDo
Phone # (
River Basin
Adj. Wtr. Body Cc. "l (nat /man &nkn1
Closest Maj. Wtr. Body 7c, m 1 Co so,- J
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Signatu� Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit0(fce's Pri ted Name
Signature
S/$/19 3�iq
Issuing Date Expiration Date
J,

�Gv gV�KNEPO �e
G v EX\SS\NG
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OQd DECK '
QP CONCRETE
POOLAREA
EXISTING
HOUSE
APO:
ppdp MOREHOUSE
APO:
HATTERAS MARLIN CLUB, INC.
LOCATION SKETCH, NOT TO SCALE
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CAMA PLAN FOR:
,z slrMARK A. PALMATIER
L� 5w��^`
57170 PEERLESS LANE
�5�� HATTERAS, NC, 27943
X Date 04/05/19 Scale 1" = 40'

I certify that I have authorized 6QRY AW6 d 7UNIFER PRICE (agenticontractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of
at my property located at 57/70 PEE2LESS td-,14477E"S, AIC
This certification is valid through
(Property Owner Information)
Signature
1✓1A 12 )< ,,4/M s-h'e
Print or Type Name
Title, co. owner or trustee for property
ql .o// i
Date
�2l0 � 61) - 3?30
Telephone Number
/2-3/• /9
3 `ly�ll�wF� P_ Snrnt.; /, ion^
Email Address
(date).

DIVISION OF COASTAL MANAGEMENT
or
1 hereby 061W that I own property adjacent to hIM d. PQLM4T/ER
'a
(Name of Property Owner)
Property located at -fi7/70 PEERLESS LA:
(Project Stts: Address, Lot, Block, Road, ebe.)
on LW4C DFi PAMUCD .WA(D in L/d &KAS
(Watsrbody) 3'EAtN/iER PRICE•
Agenf$ Narft #: a4AV PR/CR
Agent's phone #: Z52-305-G1(J7
Ply/rown and/or County)
Mailing Address: �'D ffOX 295
Avuhm, 279(S
N.C.
He/she has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
SEE A774411E0
PC* In Weag wdhln ire days of
17 SOUA EUsabeM CIW, hr. 27M.
(Property Owner Infomrstion)
SbnaWm
M49K do PALAUT1ER
" M or type Name
PO BDX 919
ti/amW Address
LEUND., N6 Z8Y57
C6y�5oatarzo
Tarephom Number/Email Address
Date
Dgiosiis
'VaW for one calendar year after signa(ure'
CWnIdlXmdwx&shorddbem0odfo f367us
ra cen ehro be corgr2hdet(2M 264JWf. No
(Ad scent PmPerrtynOwner Intormflon)
12y--
Parr or Type Name
1181 �1!M I koio
F440-T6 �u,� Ah, �83k
cnyISMIaZ,
Q(0 q13 Son
Teleph" Number/Email Address
V -23- -M
Dais'

AUUNITEDST13TES
POST/A L SERVICE
April 18, 2019
Dear gary price:
The following is in response to your request for proof of delivery on your item with the tracking number:
7018 0360 0001 6770 0239.
Item Details
Status:
Delivered, Individual Picked Up at Post Office
Status Date I Time:
April 11, 2019, 9:05 am
Location_
HATTERAS, NC 27943
Postal Product:
First -Class Mail®
Extra Services:
Certified MaiITM
Return Receipt Electronic
Weight: 1.0oz
Recipient Signature
T (94.l,11 '7I iAtri",
Signature of Recipient:
Address of Recipient: 1JII s'4...14 0M11�11111II
Note: Scanned image may reflect a different destination address due to Intended Recipient's delivery instructions on file.
Thank you for selecting the United States Postal Service® for your mailing needs. If you require additional
assistance, please contact your local Post Office M or a Postal representative at 1-800-222-1811.
Sincerely,
United States Postal Service®
475 L'Enfant Plaza SW
Washington, D.C. 20260-0004

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AGENT AUTMOnLZATION FORM FOR PERMIT APPLICATIONS
Name Of Properly Owner Applying for Permit: Af4RK 4 - PQ GMdTlER
Mailing address: PD BOk 919
ZC LAMS, NC, Z8'/Sl
Telephone Number:
I certify that I have authorized 6'QRY PVtC d ?ENA(IFER PRl[8 (agenttcontmctor)
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of W11MUD MIZ-17RIM76N
at my property located at 5717D PEEPUE•SS LN• , Ltd TTEW, AX
This cartif+cation is valid through IZ-31• !9 (date).
(Property Owner Information)
Signature
InAWK '4//0,-h',- -
Print or Type Name - --�—
Title, co, owner or trustee for property
Date
0 ,--Gla - 3�3�
Telephone Number
e �cYlc.'%,laM

DIVISION OF COASTAL MANAGEMENT
or
i hereby M" that I Own property adjawt to 4MU A P4ZMdT/EA: g
Property located at .r7170 PEERLESS G/Y (Name of Property Owner)
(fit like: Address, Lot, Blocky Road, etc.)
on LWAI OFF PAMZICO 1110 in 1/d77eXdS
(M'rt) N.C.
3 EA/AIlFER PRICE (CitY/rown and/or Courtly)
AoenfaName#: C4XVPRICE MaillnpAddress: POBOX275'
Agenfaphone#: ZS2-305-(ojoy7 4VOALAIC, 279/5'
tielShe has described to me as shown below the developmerrt He/she is pro PO" at that location,
and 1 have no objections to the proposal.
SEE 4TT4[IJEQ
R Yore nave oo/.cuo w rn What Is be
POW) In" MrrpWithin f0days of
17 $puck Mbabefh City, M4 2yM.
(Property Owner IMonnation)
sblmn
MRK do PdLMdT/ER
PO wx 919
�rrg add
LfL"Di' e, Z8Y5'1
Tafephaoe Nanrber/F_maBAdUtasd
*VaNd for am calendar year after StnWLW
t:ortsspondarreoa/watalbeaaaNadro 136T Ll4
w can also be comma odSt MV 2643M. No
Z77m
rty Owner Information)
ijQRahM9•
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TskphOrrs NtanBaw/Elneil Rddresa

UNITEDSTdTES
A MTALSERVICE _. .... ... __. _.. __.
April 18, 2019
Dear gary price:
The following is in response to your request for proof of delivery on your item with the tracking number:
7018 0360 0001 6770 0239.
Item Details
Status:
Delivered, Individual Picked Up at Post Office
Status Date / Time:
April 11, 2019, 9:05 am
Location:
HATTERAS, NC 27943
Postal Product:
First -Class Mail®
Extra Services:
Certified MaiIT"
Return Receipt Electronic
Shipment Details
Weight:
Recipient Signature
1.0oz
.I0,0 0'4IvArj."
Signature of Recipient: d
Address of Recipient: II dl,il
„ I Narrlurlrr
Note: Scanned image may reflect a different destination address due to Intended Recipient's delivery instructions on file.
Thank you for selecting the United States Postal Service® for your mailing needs. If you require additional
assistance, please contact your local Post Office TM or a Postal representative at 1-800-222-1811.
Sincerely,
United States Postal Service®
475 L'Enfant Plaza SW
Washington, D.C. 20260-0004

M
0

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: mae � (t ' � I�t'�rCr Permit #: Z7 6qA
Date:
i
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
rn h Uro�.�
Dredge❑ Fill Both ❑ Other ❑
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Dredge ❑ Fill ❑ Both [P Other ❑
Sho IIGw Q
Dredge ❑ Fill ❑ Both ;9 Other ❑
S y$Stij
5`I$ S't4
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
_
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252.808-2808 :: 1�8884RCOAST :: www.nccoastalmanaaement.net revised: 02/03110