55880D - Barefoot

iCAMA VI DREDGE & FILL
GENERAL PERMIT Previous permit#
New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / f
i Rules attached.
(6
nt Name � Project Location: County � (/lst G�
;s 6 N UyVoil, t Street Address/ State Road/ Lot #(s)
2 State ZIS P1rC.
# (� J �� Zy��p Fax # () Subdivision W, l
ized Agent Anhelvd,i I City ZIP
t1i L i
,d ❑ Cw ❑ EW El PTA ❑ ES ❑ PTS �ota # River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A C
❑ PANS
yes /`no / PNA yes no
Df Project/ Activity
iock)length
•m(s)
pier(s)
length
wmber
;ad/ Riprap length_
mg distance offshore
nax distance offshore
channel
ubic yards_
amp
)use/ Boatlift
Bulldozing
ine Length
not sure yes
igs: not su yes
(no
I
)rium: n/a
no
Ae
ro
Attached:
no -
Adj. Wtr. Body
Crit.Hab. yes / no Closest Maj. Wtr. Body
(Scale:
ling permit may be required by: (JV1 1 t �,
Ali VU.-h i-A
❑ See note on back regarding River Basin

a
660
� �
+Aam jAw wAvryl

i �
II
IF
i
,
I
j- 1
!
►
;
i
i
l
I,
i-
i----
i I
'---I_
i-...
-- ---I--- I-_
i7
I
I
{ i {

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to k.Jgq,,)i= ?� AkEi -cac'r- is
(Name of Property Owner)
property located at 7 099
(Lot, Block, Road, etc.)
on [�� � , in SJ 2;= C- , y N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: Mailing Address:3.SS: .MF44c),! 8&=. D e�
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 do not wish to waive
do wish to waive that setback requirement.
------------------------------------
--------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
----------------------------------------------------------------------------------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
aj' 'Q n e � -ly "..,
Mailing Address Signature

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to �.,paQnAi=— A ro - is
(Name of Property Owner)
property located at 7oq'l
(Lot, Block, Road, etc.)
on CANH ( ti , in -6J(Z(.: C J -jY , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 9/0--3319-a52* Mailing Address:2& D?�
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.)
9 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)
-------------------------------------------------------------------------------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit) F
Mailing Address Signature

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
el F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Sec
Authorized Agent Consent Agreement
f Cu.vS; fZJcn6IV is hereby authorized to act on my beha
(Printed Name of Agent)
�r to obtain any CAMA permit(s) required for the property listed below. The authorization is limited to i
c activities described in the attached sketch.
TION OF PROJECT:
Ly 2'D 1 677
ERTY OWNER MAILING ADDRESS:
PHONE NO. 9//)-3;2$-,p:53
ORIZED AGENT MAILING ADDRESS:
5- L i•1.
T
PHONE NO. 91D-3a�- 3N7�

C Division of Coastal Mgt. Habitat impact Computer Sheet
)plicant:
V V lJ�-y
ate: l
q pl 55$sb
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
)und in your Habitat code sheet. F t FINAL Feet
iabitat Name
ow
DISTURB TYPE
Choose One
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
TOTAL Sq. Ft.
for.
FINAL Sq. Ft.
(Anticipated final
TOTAL ee
(Applied for.
(Anticipated final
(Applied
Disturbance total
disturbance.
Disturbance
disturbance.
includes any
Excludes any
total includes
any anticipated
Excludes any
restoration and/or
anticipated
restoration
and/or temp
restoration or
temp impact
restoration or
temp impacts)
impact amount
temp impacts)
amount
1 1 1 7 _ I L-F trl

ANTINORI CONSTRUCTION
145 VIRGINIA LANE
SNEADS FERRY, NC 28460
[phone]
lie OOB 7 2 31I■
Bank of America.�e "' '
8 723
ACH R/Tp�ppp,�
66-19-530
�D 4 2010
0
0
o
$ aD0
m
DOLLARS
AU7HORIZ SIGNATURE I
1.0 5 3000 1 •
96�. 0006 50 5 2 19901,@