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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Govemor James H. Gregson, Director William G. Ross Jr., Secretary
Date 1- 5 -11
Applicant Name e-r(y I Dom L i
Mailing Address RO r3 Jx L r3
tJ" n f &cL��eA , A/c- :2 7 3I 3
I certify that I have authorized (agent) %ia�Pyl'QM4,17 A to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) hj I`ll k
at (location)
This certification is alit hru (date) 1 Z - 3 % - / 1
Signature

k3i/U.Vyuii i.i:i! JiJIO.jJ:JCf ixPuiC- r'Hkm VI
Jan u:i 11 iUsbba Hal Forlesan 310-270-3374 p.2
WCD"
North Carolina Department of Environment and Natural Resources
DivWwn of Coastal Management
to c*aW F. Earley. C-ovemDr James H. Ck peon, DIwAor Wbam G. Ross ,M.. Swewiry
u ate { . __.Z - I k
Applkattt yamc
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Nisiliar Asldrrxs
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I certify that I have authorixed (agent)
bAsIL for the pawpose of applying for and obhisiog A CAMA Permits ncccuary to
iwi%tall or cowstruct (activity) bAIZ. G s ,-I('
of
r`
Thin certiheation is valid thru (date) / �- - 3% - /
Signaturo
guu Comm me Avenue. Morehead City, worth Caroline 28557
P xw: 252-8-28M l FAX: [phone] I Internet www.nccoastalmanaotment net

11 11:39a Hal Fogleman 910-270-3374 P.3
Al" PjACEIIT;'IR.jP R/I
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(Lot or Sireti ii, Street Ro-ad)
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1by Cderd-s'.'y tat, I Civen rj,-DperLy ad,-
,as-=I,tiG iue zbove-ielbreaced proptPay- Ylke hidividual
in X^Ox axis permiA. has deswiled to me as shawm on *e Klached drawk gy the doweicTragentthey
s'"'Wid be pnuAded
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I &,Rnish to waive the 15' seth�Lck rw,-rL,,=cn+L
1 do wV-Pvish to weive the 15' sdback r-eamhumew,
Ooa� 3:3 1
Abcfel Az-;z Fakmv /IV to to E. me-

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C Division of Coastal Rrr19t. Habitat Impact Computer Sleet
plicant: LA ( C16rh Permit #:
ite:
Cj � 13
l/--�Li/10
ascribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
.rnd in your Habitat code sheet.
ibitat 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/c
temp impact
amount)
Dredge ❑ Fill [ Both ❑ Other ❑
I a O
I'p O
t
54
Dredge ❑ Fill Both ❑ Other ❑
O
W 0
Dredge ❑ Fill ❑ Both ❑ Other
9u)
9 u V
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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 ❑
Ov lifn = 12K 41In,,FrA L4";iJrd

TRINE CONTRACTORS, LLC
910-367-2159
92 HAROLD CT.
MPSTEAD, NC 28443
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3431411' I:0530001cir
Bank of America
ACH RrF 053000196
08-03
4314
66-19/530 NC
702
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