The URL can be used to link to this page

Home My WebLink About56632D - Resnick AM�u j1N� oA� ,$A'T B1 ) I b=by oortify that I oo Fwav ad*aeto s (Na:aa of Property Owaer) property Ico w at OLA WAd,6 Rook sic-) on N.G Deus. Crown aatithga' Cotuifif f o'Va�tsrbr�') ff AppikaaNapioaeb' — ,.ter....• aO19, err �Q6CR V6 Mot doafmd 10 ma as dvmu bd*w- the devebPm*c be i3 Popes at that locadM aod, I hum no objoct M as his prroycml. I ujntamd due a pier/nroorang pilings / boadiB / boa&mse coat be tat back a lnkdRmm dra m co at fdlnan Awl (IS) ftm M1 sm of ripener aacess unless waivvd by me. (If Yes VdA to —110 flee mdm-!k. You main to fial t!e appreprsaas blank below.) �N I pgj&wish to waivo 1 �I ga Wilk I* waive *a tG6mk roqobcmcnL DUCRUqWN APMM- RAWMIGOF FBOrOMD'DEVELOPA an: mo fund is by bla Pr PWkd *"*Pmvm) 0 a arauaoo for Prapwy owser Applying (RIPWiar 1 mP" Owner 10911006ri) for Permit Mailing Ad&esa '01�7 � I p N `t:N f�•� �9 0� 'DRY: RPPr� Nato Cardin Department ofyitunrrtent and. Natural Resources Division of Coastal Managen-Ant Wwaw G. Ross Jr., &4QV1afY t+liChsd F. EadsY. Governor clwries 9. lours., pirwder Authorized Agent Consent Agreement is hereby authorized to ad on my behalf (prnred NomvtAVnp The author is limited to the in order to obtain aqY LAMA penyd(s) required for PrOPMIY Gated spectric activities descried in dw attached sketch - LOCATION OF PRWVCT: 4, rs_ Y .ta ... PROPERTY OWNER MAILING ADDRESS: AUYHORIZED.AGENT MAIUNG ADDRESS: PHONE NO, A I O li -_3'f 7S� Signature of,Prapedty Owrw- X44d �-' __ _ � � � -- �, _ _. .. �w� ,_ ----- r �_ __ ,,: - _._ �. ;��-��: �- � �' �.. �. ��.: ,� " •r _ _ .' x� ry:s. .. � �� .. ,�.. � .cY�-: ��•,;� .w �, �„ � �. , s�ffi _ . C Division of Coastal N19t, Habitat Impact Computer Sheet plicant: wa'at��5►U G Permit # fe 1 scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement ind 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 final disturbance. Excludes any restoration and/or temp impact amount) Dredge ❑ Fill ❑ Both ❑ Other Dredge Fill ❑ Both ❑ Other ❑ Dredge ❑ Fill Both ❑ Other ❑ L1 W 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 ❑ U3 J 41J ANTINORI CONSTRUCTION 145 VIRGINIA LANE SNEADS FERRY, NC 28460 (910) 327-3475 BankofAmerica. ACH R/r W3DD0, 88 'I 66-19-530 Uci _Q(�e N1�1� ~� - A lCTa DOLLARS P 5� c�3ZD ORIZE SIGNA E 11100894011' 1:053000 L961: 0006505 2 L99011' 0 ■ 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: OA LTu �1 Po��c,'ZS 7a-7a 5T R�= C- f rX c a� y w,5 A. Signature X ❑ Agent Addressee B. Received by (Printed Name) C. D to of 7livery is 1 D. Is delivery address different from item 1? Yes If YES, enter delivery address below: ❑ No 3. Service Type Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7009 0960 0000 6030 9726 (Transfer from service label) _— PS Form 3811, February 2004 Domestic Return Receipt ■ 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 Feturn the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: sfltvo 102595-02-M-1540 A. Sig(1at re \ A. ' /V ❑ Agent ✓� V ❑ Addressee B. R ed by (Prfn I Name) C. Date of Delivery D. Is delivery diffeern 43_ Y If YES, delivery address JAN 19 2011 P )rA,K m C 3. Service TN RCertified Im p Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7009 n96n nnnn kn';ln R7l.q