57942_KEEL, RANDY_20110518

❑CAMA / ❑ ©REDGE & FILL
GENERAL PERMIT Previous permit#
❑New ❑hloclification El 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 I SA NCAC
O Rules attached.
Applicant Name
Address
City
State ZIP
Phone # (^)
Fax # O
Authorized Agent
❑ CW
d EW ❑ PTA O ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑ FC:
ORW: yes / no
PNA yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZI P
Phone # O `5 (`. 3 7$ River Basin
t '}
Adj. Wtr. Body fi�� <�' (nat /man /unkn)
Closest Maj. Wtr. Body
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Type of.Project/ Activity
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Agent or Applicant Printed Name
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit" Issuing Date
Expiration Date
Application Fee(s)
Check# Local PlanningJurisdiction
Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-411COAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

NC Division of k,oastal Mgt. Habitat Impact Computer Sheen
Applicant: Randy Keel
Date: 5/27/11
Permit #: 57942C
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
Open Water
Dredge 0 Fill EI Both ❑ Other ❑x
120
120
Shoreline
Dredge ❑ Fill ❑O Both ❑ Other ❑
120
120
Highground
Dredge ❑ Fill ❑ Both ❑ Other 0
600
600
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 :: 1-888-4RCOAST :: www.necoastalmanagement.net revised: 02/03/10

IXCAMA /-, DREDGE & FILL
GENERAL .PERMIT
Nevv GModification ❑Complete Reissue ❑Partial Reissue
N° 57942C
Previous permit #
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 7A, �-
\ [$Rules attached.
Applicant Name s .i Project Location: County 4 1C ',,j
Address 0UA-&?f VZ
City A.4 A State ! Vk ZIP 2 �
Phone # ( ) ZL4 1 _ L4 I�il Fax # ( )
Authorized Agent h- '.t .,{ C n ,-t
Affected
AEC(s):
ORW:
❑ CW
❑ OEA
PWS:
yes /
XEW 5Q PTA KES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ FC:
PNA yes /, no- Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City �,I�iC :��J."lip ZIP 2 j'tX;
Phone # (� 1 ") 1 ' 7 River Basin + lit
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ent br Applicant Printed Name
Signature Pleaseiread compliance statement on back of permit*
Application Fee(s) sv.awsf jai Check#
Permit #ficer's Sin ture
tt 3r• _
Issuing lbate ElxpirAtion Date
Local Planning Jurisdiction Rover File Name

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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
May 24, 2011
Antinori Construction
145 Virginia Lane
Sneads Ferry, NC 28460
Dear Mr. Antinori:
Attached is General Permit #57942C.
In order to validate this permit, please sign the permit as indicated. Retain the white copy for
your files and return the signed yellow and pink copies to us in the enclosed, self-addressed
envelope. If the signed permit copies are not returned to this office before the initiation of
development, you will be working without authorization and will be subject to a Notice of
Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely,
Barry Guthrie
Coastal Management Representative
BG/lsb
Enclosures
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post consumer Paper

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to: , _ ,' iLV
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A. Signatu s.;. ; "'�'�:%f r i. 1.. }� ' ::'x
❑ Agent
X ❑ Addressee
B. Received by (Printed Name) C. pate of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
'ZCertlfied Mail ❑ Express Mail
❑ Registered ❑ Retum Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (EWra Fee) ❑ Yes
2. Article Number
(transfer from service label) 7008 0150 11000 5544
5 3 6 3
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
X otN tv

■ Complete items 1, 2, and 3. Also,complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
A. Si ature
X
❑ Agent
❑Addressee_
B. Re I ed by (Pr' ted Name)
C. D to of Delivery
c
'i so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is delivery address different from item 1?
If YES, enter delivery address below:
❑ Yes
❑ No
1. Article Addressed to:
ry�
C%x
3. Service Type
>( Certified Mail ❑ Express Mall
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
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4. Restricted Delivery? (Extra Fee)
❑ Yes
2. Article Number
(Transfer from servicefabeq 7008 0150 0000 5544 5356
PS Form 3811, February 2004 Domestic Return Receipt
102595-02-M-1540

UNITED STATES POSTAL SERVICE
:ecYlk 4-A. I L-Z
4�ender lease print your name, address'"•and"2tF
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NCDENR
North Carolina Department of Environment and Natural Resources � � y
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
Authorized Agent Consent Agreement
flM—X--s fc� C-C,-t,,''z C2ni is hereby authorized to act on my behalf
(Printed Name ofAgenr)
in order to obtain any CAMA permit(s) required for the property listed below. The authorization is limited to the
specific activities described in the attached sketch.
LOCATION OF PROJECT:
Jr1CK--'0r'�'v 1� MC RSSIA Q
PROPERTY OWNER MAILING ADDRESS:
PHONE NO. 2.� a - 141 - L-i )c�7
AUTHORIZED AGENT MAILING ADDRESS:
l q.5 V l iZg�'r>31!1 i ri .
.5 yl ;✓ !� Z"5--��'� tv� � aZ ri y Gad
PHONE NO. q 1 G 3,a - 3,i 21S-
Signature of Property Owner.
Signature of Authorized Agent:�,���
Date
127 Cardinal Drive Ext., Wilmington, North Carolina 28405-3845
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagemenI.net
An Equal opportunity i Affirmative Action Employer - 50% Re ycied'.1,j% post Consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTIBOATHOUSE)
�RECF
IVED
I hereby certify that I own property adjacent to �v �-� s
(Name of Property Owner) MAY 2011
property located at 1 ? {3-Z.VZ7-0r-k '�`+ .
(Lot, Block, Road, etc.) �- r
on N E7t� S-'3y�= ' , in C-) My t �_ N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: ,Z , --A-) ! `l t `! 2 Mailing Address: l 7,D -> S .)tu S; Avi=
IJ
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
1/ �
I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
F 2 C, i ,1 -5
Mailing Address
RaLt:i T,1fA ' i-4 C. 7;�
City/State/Zip
(Riparian Property Owner Information)
Signature
x M a. e rl' n a. Alz rn- FOX
Print or Type Name
;k,5.2---3L-iI- IIi,? x q/o - 3417-l'gl/,
Teleph ne Num r Telephone Number
Signature Date Date

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9095
BankofAmerica.
ANTINORI CONSTRUCTION ACH R/T M3000196
145 VIRGINIA LANE
SNEADS FERRY, NC 28460 66-19-530
[phone]
j28.j
0
PAY TO THE
ORDER OF: oo 9
DOLLARS
MEMO
1130090951" 1:053000L'ID: 000E5052L990110
AUTHORIZtD SIGNATURE
4

Mai 16 10 04:21p
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P.1
A N T I N 0 R I
CONSTRUCTION
145 VIRGINIA LN
SNEADS FERRY NC 2e460
PH 910 3E7 3475
FAX 91 ❑ 327 0135
FAX
TO:
FAX #�t`7 3 3 3C
FROM:
DATE: 5 ! )-,? 1 � I
COMMENTS:Ca�.21'
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Mai 16 10 04:21p,
p.2
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr.. Secretary
Authorized Agent Consent Agreement
Pr -'a, '-'\U;ti c C,N'�i C?; : _.: kc:�,.l ' is hereby authorized to act on my behalf
(Printed Name ofAgent)
in order to obtain any CAMA permit(s) required for the property listed below. The authorization is limited to the
specific activities described in the attached sketch.
LOCATION OF PROJECT:
PROPERTY OWNER MAILING ADDRESS:
PHONE NO. ; -+41-441 �7
AUTHORIZED AGENT MAILING ADDRESS:
PHONE NO. q 1 v -
Signature of Property Owner.
Signature of Authorized Agent:'/'.f�l
Date:
127 Cardinal Drive Ext., Wilmington, North Carolina 28405-3845
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.r.et
An Equal opportunity t Affirmative Action Employer - :C o Recyc ed' 10°i Wiest Consumer Paper

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Matj, 16 10 04 : 21 p
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIEAIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at 1'7,.,
(Lot, Block, Road, etc.)
on - `v',v;=. inN.C.
(Waterbody) (Town and/or County)
Applicant's phone :A 41 r 3 cf ? Mailing Address: i tlj - ts/j�
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
"N � I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
(Riparian Property Owner Information)
Signature
A)n rt_ Fox
Print or Type Name
Teleph e Nam r Telephone Number
V
Signature Date Date

Ma�j'16 10 04:21p
p.5
■ Complete Items 1, 2, and 3. Also complete
Item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
(�19CRtY1r1 -jC,X
L
JP�C-Y--50;') v ► ux. , iv C .
H. �r acura
❑ Agent
X ❑ Addressee
B. R ived by (P ' ted Name) C. to of Delivery
D_ Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
XCertliled Mail ❑ Express Mail
❑ Registered ❑ Return Receipt far Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) 0 Yes
2. Article Number
(lransferfrom servicefabeq 7008 0150 0000 5544 5356
PS Form 3811, February 2004 Domestic Return Receipt 102595-02•M-1540
;• Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
?w)NE\A wX b `2c 311.t �1s1t1
5,)LLI )A»r-N ea av�
12 N7 ��•
a3'4's-1
A. Signatu w.. �... M. P-0
❑ Agent
X - �� L7 Addressee
B. Received by (Printed Name) C.,PaJa of Delivery
D. Is delivery address different from item 1? 0 Yes
If YES, enter delivery address below: ❑ No
3. Service Type
;54Certified mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mal 0 C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7008 �1,50 CI000 5544 5363
(Transfer from service fabef) _ =-.-.- -- ---- - - _---
PS Form 3811, February 2004 Domestic Return Receipt 1°z595-024'1-15410

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