HomeMy WebLinkAbout76104D - JordanCAMA / DREDGE & FILL NO. 76104 A B C
64bENERAL PERMIT Previous permit #
New Modification ❑Complete Reissue []Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality I
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC o� K • 1 Z U o
\ \ A ❑ Rules attachh�
Applicant Name C,,� 4 t J o- ci o-1 Project Location: County 1 ' "1r" v—
Address A au Street Address/ State Road/ Lot #(s)
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City ��, � G � � State 3 _._ �o �� ,c.�G`14
Phone # (h) Z (,,l E-Mail r r<< F Subdivision
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Authorized Agent �� 0sn' City C. cZIP' S
Affected ❑ CW A EW X'PTA ❑ ES ❑ PTS Phone # ( ) River Basin 1 t r•
AEC(s): ❑ OEA ❑ HHF ❑ lH ❑ USA ❑ N/A Adj. Wtr. Body G
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❑ PWS:
ORW: yes /�� PNA yes /� Closest Maj. Wtr. Body
Type of Project/ Activity -.)� k\ Y1i� \A (J v
Fixes
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A building permit maybe required by: ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) t
Notes/ Special Conditions_, 1 . `,� -1�� .�� na� C'r` ��Ua� �" �d U
( n-'r. a- U."
MATT N
Agent �ApplicantPrintllie�"�
Signature "Please read compliance statement on back of permit"
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Application e(s) Check #
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Permit r s ted (dame
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Signature
212 2eZ4 2' ZAL0
Issuing ate Exp tion ate
AGENT AUTHORIZATION FOR CAiMlA PERMIT APPLICATION
Name of Property Owner Requesting Fermi
Mailing Address:
Phone Number:
I �43 - <QtQ�t - yk�
Email Address: 41121 CQa •. Q 'Y--, r-c,k 9 o-�—�i'c�L_
4-3
1 certify that I have authorized VA S IC,L> o r 1- C- ,
Agent / Contraclor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
7Y-AA-.s t-Z1 � b o c4 44
at my property located at .11 1..� lam►.. -�.-
in u ..ativ� e County.
I furthermore certify that I 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:
Sign ure (�
Print or Type Name
C> L4--> re.--
Tttl@
Date
This certification is valid through I I
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CONSTRUCTION
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Columns
Colwnn9
COI m 7
Cokunn9
COWmn9
3/26/2020
H5 Construction, LLC
Thomas Jordan
BUT
2486
$ 200.00
GP #76104D
BB rct. 10861
3/26/2020
Ralph & Colleen Graham (1 of 3)
same
Wachovia
1205
$ 200.00
GP #75801 D
BB rct. 10923
3/26/2020
Ralph & Colleen Graham (2 of 3)
same
Wachovia
1204
$ 200.00
GP #75801 D
B_B rct. 10923
3/26/2020
Ralph & Colleen Graham (3 of 3)
same
Wachovia
1207
$ 200.00
GP #75801 D
BB rot. 10923
3/26/2020
Oceanside Management LLC
same
First Bank
31081
$ 200.00
GP #76276D
I BB rct. 10925