56614D - Toomes

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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary
Date I -5 1 ►
Applicant Name ► oom e;
Mailing Address 'PO vx Z d Y
ileAJU if 61-VAn /1/4- •�2 7 3% 3
I certify that I have authorized (agent) rQfl4,P7 9111'a 41441%zto act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (location) 1, & , C, r Y K
This certification is valid thru (date) 1 Z 3 f / /
Signature

.,an ua 11 1usa5a Mai forleraan 310-270-3374 p.2
MCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
M ttt el F. Ewlay. Gomm James K Cgep t1. DlrKWr MOM G. Rosy Jr., Sevetwy
Applicant dame
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Mailing Aildmam,
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1 certify that 1 have authorized (agent) h%Z l�jt� /Ql�� "ii' 4 ��•�tu Vitt an my
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briralt; for the purpose of app"l; far and obtaining all CA MA Fcrnnilts necemary to
inaall or construct (activity) bb JM G s,,'(' _
of
TIVir certiliicativa is valid thru (data)
400 Commerce Avenue, Morehead City, North Carolina 2&%7
Ptrx*: 252-800-28W k FAX: [phone] inlemet www.necoastalmanwment net

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Uehu.r,!K: Numtzxx -.WiL'l Code

C Division of Coastal N19t. Habitat Impact Computer Sleet
plieant: ' pbYy� Permit #: � j Li �
te:
V-0-?- 11-4
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ind in your Habitat code sheet.
bitat 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/o
temp impact
amount
Dredge ❑ Fill Both ❑ Other ❑
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1
Dredge ❑ Fill Both ❑ Other ❑
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O
4�
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 0 Other ❑

MINE CONTRACTORS$ LLC
910-367-2159
92 HAROLD CT.
kMPSTEAD, NC 28443
5,� (,PF,))
08-03
I:053000196l: 000684
Bank of America
ACH R/T 053000196
4314
66-19/530 NC
702
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