55832D - Boyette

CAMA / - DREDGE & FILL
E N E RA L PERMIT Previous permit #
New • Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
-oastal Resources Commission in an area of environmental concern pursuant to I SA NCACOQ
�[ ' • 1 I ' I Rules attached.
It Name V �rr�irrY�A_L ��iFt_ Project Location: County On)Lby
12o tK or. Wa 1 k Liu-
Q Street Address/ State Road/ Lot #(s)
U,1 Tu\ State ZIP 2832,9, j!�d s.PQ-�
t 7119 Fax # ( ) Subdivision 00 & Me Vs &ra c- .
:ed Agent Nth- l &s+. /AI City ,iUVt i1, ZIP_
ElCW NEW ❑PTA )<ES (PTS Phone # �1IO-)-3}XI -�S3-4S River Basin
❑ OEA El El ❑ UBA El Adj. Wtr. Body 1 S O(A AM S (nat
El PWS: [I FC:
yes / no PNA yes no Crit.Hab. yes / no Closest Maj. Wtr. Body � Yyi i2 5o U r) et
Project/ Activity
length
pier(s)
'length
camber
tad/ is ancprap tength
offs
ivg distance offshore
nax distance offshore
channel
:ubic yards___
amp
Ruse/ Boatlift
Bulldo�ziing
ITI X I '
SS
ine Length
not sure
yes
no -_i.
igs: not sure
yes
no
xium: n/a
yes
no
s.
yes
no
r Attached:
yes
_ T
(Scale: 1 11
ling permit may be required by:
IM
❑ See note on back regarding River Basin

Y I XI(o� l
---- - ....... - -

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A pEF%y00JUNG PILINCSBOATUFTIROAYHOU-M
I hereby certify that I own property adjacent to kZ PVM ?_CL' xR y ry� a
(Name of property Owner)
property located at 40(url
(Lot, Block, Road, etc.)
on rah).AL _.in r12:�? , N.C.
(Waterbody) (Town aod/or County)
Applicant's phone N: g lO Jre�'�71�NLiiiaR Add'—. (aO D i E-Yi��uD AGE LAI
CM-s'11Il , NL ag 3-1F5
He has described to me, as shown below, the development be is proposing at that location, and, I
have no objections to his proposal. I understand that a pierimooring pilings / bontlift' boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waivedbX me. (If you w-isb to .naive the setback, you must initial the appropriate blank
11 below.
\(� I do sot wish to waive
iC 1 dg wish to waive thar setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individrol proposing developmew)
(Information for Property Owner Applying (Riparian
for Perm'.o,�ol,�all�
YMZ�
Maailin Addrt�s
Signature
/� ? pr
71,
City:'Si 6sip
A/p -'5'90 �? 7� n
— —
Print ar Type Name
9�� -9% - a- 4
Td umber
Telephone Number
Signature Date
Date

L0/4V1V lueou r•AA D1V JaV LJL1 l 1 'J vv-a
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FORA PIE-AWOORING PILWG"0ATLWr,BO�AaiHOUSE)
I hereby certify that I own property adjacent to lL 1'*1yM 4)
(Name of Property Owner)
property located at 3U42C) 3T 2i _�JRr= C-I'i'•q
(Lot, Block, Road, etc.)
(Waterbody) (Town and/or Comrty)
Applicant's phone it; 9 /D ��'�71 DMailinA AAdreas: Qj� —h _LA") Rt.r_ l J�
S{�u rn N4 RS 31s-
He has described to me, as shown below, the development be is proposing at that location, and, I
have no objections to his proposal. I understand that a pierimooring pilings / boadift' boathouse
must be set back s muutnum distance of fifteen feet (I Y) from my area of riparian access unless
waived by rne. (If you wish to waive the setback, you mast initial the appropriate blank
Mow.)
),L _ I do not wish to waive
142 wish to waive that setback requirement.
--------------------------------• - ----- ------•-------------•---------------------------------------..
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To br filled in by individrml proposing development)
---- --------------- --------------------------------------------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit
Maili�Addm&% n Statattrre
City'State;Zip t Print or "f} lvatnc
7rl umher �elephone Number
X
Signature llate Date

4vl Lulu 10;J0 rAA 01V J.7V GJG1 JawV num ll.l J------11 'L'JVVV
NCDENR
North Caroltna DFl.arlment of Environment and Natural RPsourres
Division of Coastal Management
t•:i::.hae� F Eas±ey, 6rrrcmot Charles S. Jones, Director 'William G. Ross a.. Seaeurr
Authorized Agent Consent Agreement
�IVTiNDr2� % .�C%/QJ is hereby authorized to ad on my behalf
(Pm1W Name u/.1ys.t, ------
in order to obtain any CAMA permit(s) required for the property listed below. The authorization is limited to the
specific activities described in the attached sketch
LOCATION OF PROJECT:
SIM
PROPERTY OWNER MAILING ADDRESS.
!a0 D1)6S- 2 S �?134L
-ant-,.j r a u?3a s
PNONE NO. 9/0 -5 Cj6:! 719
AUTHORIZED AGENT MAILING ADDRESS:
1�t5_ v JR6 16 4,A1
PHONE NO.
Signature of Property Owner.
Signature of Authorized Agent:
Date:
127 Cardha± Nye E.((. Wdrmgton. rialh ^_x��hna 2e,05.384i
Phone :+10-:55.7215±FAY, g± 255-3(AA'.h±ernrt rraw.rrroas aU nartag[fienl.nel
in za:i±C4Da4aci.A6m±e.�;..�a,£7*f= -`-(`1 Rr_�a•. e.+�s G.+�sw. 1aP.

C Division of Coastal Mgt. Habitat impact Computer Sheet
PPlicant:wwao
, 1� U
y
ate:
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
ound in your Habitat code sheet. Ft TOTAL Feet FINAL Feet
TOTAL Sq. Ft. FINAL Sq. for. (Anticipated final
(Applied for. (Anticipated final (Applied
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
Habitat Name Choose One includes any Excludes any total includes Excludes any
anticipated restoration any anticipated restoration and/oi
restoration or and/or temp restoration or temp impact
temp impacts) impact amount temp impacts) amount)
Dredge ❑ Fill, Both ❑ Other ❑.
Dredge ❑ Fill ❑ Both ❑ Other ❑ U
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 ❑

ANTINORI CONSTRUCTION
145 VIRGINIA LANE
SNEADS FERRY, NC 28460
[phone]
BankofAmerica .'
ACH R/T 053=196
66.19-530
ER OF: / V C '7 /4 ."C h�p4 , ! la
/0
HOAc QAZ 'C� DOLLARS
' 00 ���J%I�� � •��
A`r-cL�
AUTHORIZED SIGNATURE
110008 6 20,10 I:0 5 3000 19 61: 000 6 50 5 2 19 90ti'
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