57581D - Gianniatasio

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American Fish Company
00 Box 11046
Soutngort. North Carolina 2846,
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-910►457-5488
910) 457-6551 F
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North Carolina Department of Environment and Natural Resources
ulvision of Coastal Management
Micthaei F Easiey, Govemor James H. Gregson, Director William G Ros.
Authorized Agent Consent Agreement
rvm rv-\--1 6 e4'
in order to obtain any CAMA pe
Vame or Agent)
is hereby authorized to act cn m-
t(s) required for the property listed below. The authorization is lirni
specific activities described in the attached sketch.
LOCATION OF PROJECT:
1--AJC Z 4Cs
PROPERTY OWNER MAILING ADDRESS:
PHONE NO qJ0 -61 of -t%-7�
----------- — ----
AUTHORIZED AGENT MAILING ADDRESS:
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PHONE NO. CIO - q!T'7 - 5 yg'g p
licnature of Property Owner:
signature of Authorized Agent:

NWne or IndIviduai Applying For Fern-Ut:
. GLILL l /�Xw 14, t4S/ a
Address of Pr:)per,.y----_---
c S,reet 0, Streec or Roac
()OAK �� a-�� (a JS UJ cc
C-v ar.d County; �
creov certify i,� t I owr•1 property adiaeent to the arove•rcfcrcr`ec aro c--�
uppl}'.ng for ti'.is Permit has described to me US snown on Inc ar9ecr.e;; p The in
are proposine. A dcscri Lion or drawing, with dimensions. snou;c .. 71,V„°;r` devcloprY
With thss 1
Oe,h hire no Obiections Io
have ab;ections to what is being proposod, nieasn ��r�rr tnc o
1�laoagement, IV Cardinal Drivo Extewion, Wilminpoi, NC f
10 days of recoipt of this notice.
No response is considerej ;;,c ;amr a,
�'au hs.e been norii'ed by Certified Mail. abje
WAIVER SAC-jG-,
1 uaderstana tnat a pier, dock, mooring pilings,
bck a minim�e-ni distance of 15' from my urea of riparian (cc,P1.�rU sL G- no;;;
ic6 Ia w oi"'e '1'e scrbacic youe" 'J Me.
MUSIC initial the aI propri4!c ri : K ``ir,,,t
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'nnI `erne AW"r

^41ELrr►e
Of Applying For Permit: G .
���v�v�-fist �
gdc..•css of Pr--per-,,-
S.,eel 0. Sr-ezr Cr Rod --
art Co:;n —
ry;.
1 Property adjacent to the aeove•reFercr.e` a-oRe^.. Trie rn
aPRi:'`n$ Ior t-is permit has d-scrbed ;c me uS ;,
are Prop �o'n on tr,t cteacr.e ;ra,,,p : e deveiopn
os'ng dcsc-'puon or drawing, with dimensions, sbo-; -. J �.,t„-J;,,, with this
/` - — •"'�LC n0 ObltCtf0t1S t
no;ecrions to What is being proposod, p►easc N,-Tire }r L of
Management, 127 Cardinal Drive Extension, Wilmin�*ren, 'NC
�it6io 10 days of receipt of this notice. No response is conside'e ; b}� z� mL <.„~. vb'e
ou h�.e een ^otif'cd by Cerd led Ms;l
WAIVER SL CT.C-,
ucderst;.nG t ;at a pier, ooc
P ic, tn.aoringpilinss, bronic��n(er. Doc:,:sc or oo�. . t
�Ch 3 minimuni distance of 15' from ' mu.
rtty area of ripar;an cccdss
sic ;� "0ive �''e c^tbacic, you must initial the anpropr;arc h;a:
=Q iSn :0 w9sv� rh.+ Se'S�Ck re_t moo.
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ilicarit: 'GI ftM) f 771-910 NIC4C.
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Permit #: C 71
cribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen
id in your Habitat code sheet.
itat 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 fins
disturbance.
Excludes any
restoration and/
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other o
lJ'r�
Z-40
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑