HomeMy WebLinkAbout89206A - Lombardi, Tony%❑CAMA ❑ DREDGE & FILL NU 89206 ^ a c D
Previous permit
GENERAL PERMIT Date previous permit issued
[qNew El Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC 0 "� f -!" ❑ Rules attached. u General Permit Rules available at the following link: www.deq.nceov/CAMArules
Applicant Name 1 G v. ,.I k 0_s- G
Address I A 1n.'Iri34� f.<'� L_oo v
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City `�.-'q oA t- wN `kct g'z State zip,
Phone # t(_p ) Lz..2. — `� 5 zi l>
Email r_ i 10 V. .J Olnl«) nsvt 4.,I CO %V�
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Authorized Agent Yir E uJ -, n.'�A 95 <, r"
Project Location (County): Pra, r c
Street Address/State Road/Lot#(s)
Subdivision C Ft h o ts- V.
City `. a JIIA<rrL ZIP 2'19>A'9
Affected ❑ CW DW [TPTA ❑` ES ❑ PTS Adj. Wtr. Body Cc ¢ t { „ Gt A yJ t 4 C,ed 44- (nat/man/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body CL"I'-iluej=-
ORW: yes/no PNA yesIo
Type of Project/ Activity 'r •'1_ n o J U �Ir� �� ect =1 r a._c N c`K I. ; F. do r-'k-
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Access Length
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NONE
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Total Platform area
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A building permit/zoning permit may be required by,rn,.u:� key h J�ot'
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
1 AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permits'
I !, Za_
Application Feels) Check 4/Money Order
Signature
Issuing Date Expiration Date
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
Kitty Hawk, Nr: 97g4a
-70 3 1 0
i\0 `A �
Agent
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
r
necessary for the following proposed development: 1 Lam n 1 NOS x ' '. '"
at my property located at
in (' . County.
l furthermore certify that l 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:
Signature
Anthony C Lombardi
Print or Type Name
(X),- e,V
Title
07 / 10 / 2024
Date
This certification is valid through t t
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1. Article Addressed to:
�1^ZlVl�e. �' Ks��leev� CYUIo�-{
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9590 9402 5501 9249 3780 21
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7022 3330 0001 7782 1026
PS Fo ,
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so that we can return the card to you.
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or on the front if space permits.
1. Article Addressed to:
the Vy1Cl hVh uLj kvin tas']
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A.
X
B.
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Product Information S YII� ( (� y I I �
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9590 9402 5501 9249 3780 38
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