49106D - Bolin

Li
CAMA/ ❑DREDGE & FILL
IEN ERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
•ized by the State of North Carolina,Department of Environment and Natural Resources
:oastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC H 1 Q,
Rules attached.
tName ^-NCAN 1 �vnsa.J \-,a..rJ Project Location: County e QSt_ow�
27) •c:" c �' �--c ti- Street Address/State Road/Lot#(s)
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ad Agent `\ i-S:w. 4-I City S►) a ..S •L. (-r(-`) ZIP ' Li 0
❑Cw %EW I PTA ❑ES E PTS Phone# ( ) River Basin W W'l-E
❑OEA ❑HHF ❑IH ❑UBA ❑N/A r
Adj.Wtr. Body Y t.-0_4 ; , 5 (_.fL,i z*v... (Fa-Oir
❑PWS: ❑FC:
yes /() PNA ( / no Crit.Hab. yes / no Closest Maj.Wtr. Body C\✓ )LZ u1= /L
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not sure yes C �
ium: n/a yes �t }
siYes ��\ttached: yes no
ig permit may be required by: Cf 105 L. D .-" C\n.J-C ' 5 I I See note on back regarding River Basin n

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Bankof America.
RI CONSTRUCTION �'l®
35 VIRGINIA LANE
,DS FERRY, NC 28460 66-19/530 /0--ii-y /
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Artri
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
hael F. Easle overnor Charles S.Jones, Director William G. Ross Jr., S
/ _____ • Agent Consent Agreement
•
i ..rikNEo
.Al ; . is hereby authorized to act on my bet-
(Printed Name•i'Ag•nt)
der to o. _ .. CAMA permit(s) required for the property listed below. The authorization is limited tc
:Lc activ ies described in the attached sketch.
:ATION OF PROJECT:
3 al Ct-I' t- /r/! ../fa �s
1PERTY OWNER MAILING ADDRESS:
PHONE NO.
HORIZED AGENT MAILING ADDRESS:
}iuTixlbrl
&5 VA, Ak" V�
&(-'70
PHONE NO. .3t,7 - �y

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete Items 1,2,and 3.Also complete A. SI ure / ��'
x �f
item 4 if Restricted Delivery is desired. ( 0 Agent
• Print your name and address on the reverse
so that we can return the card to you. ❑Addressee
• Attach this card to the back of the mailpiece, 1.,. Receiby(Prinam� C. Date of Delivery
or on the front if space permits. e11��,l� T I7�)
1. Article Addressed to: D. Is delivery address different from item if? El Yes
If YES,enter delivery address below: 0 No
EliSTEZN I NV E 1 M EN' PQOPHz.71gi
3i9 DEEpLzexo C-
`E...i11VC) w\ . as y�/ 3. Service Type
{V Certified Mail 0 Express Mail
Registered 0 Return Receipt for Merchandise
0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7005 3110 0000 0502 7775
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt
102595-02-M-1540