45900D - Lee

•
V
IS CAMA/ DREDGE & FILL
3ENERAL PERMIT Previous permit#
SI'New JModification Li Complete Reissue El Partial Reissue Date previous permit issued
irized by the State of North Carolina, Department of Environment and Natural Resources u ,
-1 1 Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 1.. 0 1-2'''"
[$Rules attached.
t Name .1)c.W f\\I .,)L L.i 1' Project Location: County O.JS L L.....)
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Attached: yes

ANTINORI CONSTRUCTION Bank of America.
or
SNEADS FERRY, NC 28460
[phone] 66-19/530
PAY TO THE - `-"L
ORDER OF •
$
•
MEMO 51� �,D # �/ / '
--� ��YJI • AUTHORIZE SIG E
II'00 5 5 LOII' I:0 5 3000 L 96i: 0006 SO S 2 L 99OII'

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- DIVISION OF COASTAL MANAGEMENT
N ere ofIntividostApplyingFor Permit 0 Er-, R
Address ofPPuly_ l O5--
(Lot or Steet g,Street or Road)
01?.._F C Yr'?
(City sod County)
xeby certify that I own property airjacent to the ab ed
P
ePP f+arthispermutbes odtonaeas anthem d the
A description ordrawing,with tliniensions,should be p d with th -
(4• awe no objections iusproposal. _
f ri have objeerman to what is being proposed, please write the Dbt-
agementi 127 Carl Drift NC 28405 or s$!MGM 1
i$days ofreeeiptef1 No response bl tiesame aino
have brae not feed by Certified Sat
WA •.
i lersi:awd that apier,ilee34proorig Ohms,brealowaturs bent house or-beatligasstbi
13c anthems=thstanceof151frota wiy area of riparian access-rimless waived b1 sae.
a isbt to waive the setback,you awwast initial the appropriate blank below.)
I do wish to waived I3'setback zapiraseut
Iijanstleida*maim Ike 15'sodneklegnievnent.taw Date
A 1 . tI _ - -

S
I, z give authorization to
Antinori Marine Construction to act as the
contracting agent in obtaining and signing for the
requested CAMA permit.
Job site address is:
as5 5 5c
J Q, C \ `� , 1�
My permanent address is:
Sob 3EiN(51._� RD
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Signature/
item 4 if Restricted Delivery is desired. /� Cl Agent
• Print your name and address on the reverse X A Ail/ /' CI Addressee
so that we can return the card to you. B. Received by(Prin ed • • C. Date of Delivery
■ Attach this card to the back of the mailpiece, fre i 'OZ
or on the front if space permits.
D. Is deliv= address different from item 1? ❑Yes
1. Article Addressed to: If YES,enter delivery address below: 0 No
1..A2R9 it ogee3