54138_GUILLEMETTE, GILLES_20090604

❑ CAMA T ❑ DREDGE % FILL
GENERAL I�R&41T
[]New ❑Modification , []Complete Reissue
Previous permit #
❑Partial Reissue Date previous permit issued
1
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
i] Rules attached.
Applicant Name
g'
Address ? m oL2 }-} •
City
State t� O
f
ZIP
Phone # a' ) ��' �7 r Fax # ( )
Authorized Agent
Affected ❑ CW
❑ EW L'7 PTA ❑ ES
❑ PTS
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 ZIP '2 L z)
Phone # River Basin
Adj. Wtr. Body i t �� n man unkn
Closest Maj. Wtr. Body f� `"
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,Agent or Applicant Printed'Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
PermitOfficer' SigAture
Issuing Date Expiration Date
Local Planning Jurisdiction 1 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 Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888-4RCOAST
Location: Fax: [phone]
2728 Capital Blvd. (Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604 New River Inlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
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

I(CAMA / DREDGE & FILL 54138
GENERAL 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 r 1
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 7 N , 2-a o
� ixjtules attached.
Applicant Name 1'C ' I'll? v� o- Project Location: County_ a,� [)t ul _
Address
City M �Gy�STn- ���! State I � b ZIP q 113
Phone # (66 ) -]�1' 52 Fax # (_ )
Authorized Agent y,-fi; r\vr• Con��'�'�='jt��
CW &EW )(PTA
Affected oEA HHF IH
AEC(s):
PWS: FC:
ORW: yes / QoC PNA yesn
Type of Project/ Activity C ,
Pier(dock)length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ oatlifn j � n I s
Beach Bulldozing
Other
Shoreline Length ISO
SAV: not sure
yes r(
Sandbags: not sure
yes
Moratorium: n/a
yes
Photos:
yes
Waiver Attached:
yes �n,
A building permit may be requi
Notes/ Special Conditions
en or Applicant Printed Name
ES PTS
UBA N/A
Crit.Hab. yes / no
�� C
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Street Address/ State Road/ Lot #(s) _
--- - -- - - i (-) e 45"" +1 N; j
Subdivision
City 1 ZIP
Phone # (i(lQ) _ River Basin
Adj. Wtr. Body_
Closest Maj. Wtr. Body
KEW tiJ
12�s5:�
(nat Lman /unkn)
(Scale: 1 �— I()
Permit Of ii ' ermature
' 6� bil L1101
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name

r
ANTINORI CONSTRUCTION
145 VIRGINIA LANE
SNEADS FERRY, NC 28460
[phone]
N
7639
A
a
PAY TO THE
ORDER OF: zoo.
b. c� o
7126 00
&n DOLLARS
MEMO ' ) C
Bank of America.
ACH R/T 053000196
66-19-530
11'00 76 39115 1:0 S 3000 1961: 0006 SOS 2 19901i'
N
8
AUTHORIZE GNATURlE

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson
Governor Director
June 5, 2009
Antinori Construction
145 Virginia Lane
Sneads Ferry, N.C. 28460
Dear Sir:
Dee Freeman
Secretary
Attached is General Permit 454138C to install a 13' X 13' boatlift on property owned by Gilles Guillemette, at
108 Sea Gull Way, Hubert, N.C., in Onslow County.
hn 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/rb
Enclosures
400 Commerce Ave., Morehead City, NC 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer
ne
NorthCarolina
Naturally

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
�aH7-11413zl CDAJ'26 ��t>rT A is hereby authorized to act on my behalf
(Printed Name of Agent)
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.
xLOCATION OF PROJECT:
-cr
�-
PROPERTY OWNER MAILING ADDRESS:
u,ci�3 X &41 c ? nL Sla'
PHONE NO� -- 4 �j --- / S2_�
AUTHORIZED AGENT MAILING ADDRESS:
agvGo
3 y7��
PHONE NO. 9//) - 3a2-
xSignature of Property Owner:
Signature of Authorized A
Date: S%�9
127 Cardinal Drive Ext., Wilmington, North Carolina 28405-3845
Phone: [phone] t FAX: [phone] Internet www,nccoastalmanagement.net
An Equal Opportunity AffirmaU�e Action Employer - Se% Recycled 1 10"/o Post Consumer Paper

2
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOBATLIFTOATHOUSE)
I hereby certify that I own property adjacent to 4�;i
i 11e_S 6U t (leme k e , 's
(Name of Property Owner)
property located at
Block, Road, etc.)
on e cut , in (-- %tic ' N.C.
(Wate •body) (Tov�n and/or County)
Applicant's phone #: 916 G4-� L'OS Mailing Address:_ 19�Z Wej G244
AfaaIks c
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 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)
NEW
say
C 11J
(Information for Property Owner Applying
for Permit)
463
Mailing Addr s
ofIL Nc. �� -53,9
City/State/ZG p
8� 5
G15 I S2
Telephone Number
gna Date
(Riprian Property Owner Information)
Signature
Print or Type Name
of OIL.
Telephone Number
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to �t �����at x I%n?L is
(Name of Property Owner)
property located at
(Lot, Blo4, Road, etc.)
on in , N.C.
(Wat rbody) (T-6wn and/or County) '
Applicant's phone #: Ivy' Mailing Address: w, a-�✓�C��
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.)
l I do not wish to waive ,•/r /4yl301c'$ /N 7-4-9 L 5
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
NEW
IJ
oa
L i - <.
a
-------------------------------------------------------------------------------------------------------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit) NEl6HQ0� S
y AN 1
Mailing Addo s
y
City/State/Zi
/I- KI � r I �2
Telephone Number
All
Si re Date
t�
�— Signature
Print or Type Name
Telephone Number
-31��r vy
Date

•
ANTINORI CONSTRUCTION
145 VIRGINIA LANE
SNEADS FERRY, NC 28460
BankofAmerica .���
ACH R/f 053000196
66-19-530
763
[phone]
PAY TO THE
ORDER OF: N . C • L). !` Al. $ --2 ©C)
- L�NoI2rn !<J/ O - DOLLARS
MEMO -;CIv;v'
11100 76 39110 1:0 5 3000 1961: 0006 50 5 Z 1990111
I
AUTHORIZE IGNATIRt