44872D - Maliszewski

ZAMA/ r.i DREDGE & FILL b
1EN E_RAL PERMIT Previous permit#
New Modification F Complete Reissue CPartial 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 / t-
Rules attached.
t Name i t h M NI_T. 5-La ,A./5 1L Ir Project Location: County S L, --.)
4 p 1 A Q P k. 6 Li 4\0_ j---*-) Street Address/State Road/Lot#(s)_
$,21.(z)0tL0kA(.7+ State PI\'a ZIP 01---)52- 1--)Z b- AeNr.,,,,,,o4.V- Qoss ► .-4
( ) Fax#( ) Subdivision ?C L-Z C +�t r....) 1�z=a�
ed Agent A w.7 3(LT `(li1 A t &' City 5 0 EA b 5 1��.--'�R-►t'/ ZIP`2o k I
cw W f TA ❑ES ❑PTS Phone# ( ) River BasinVv f421 t
OEA ❑HHF ❑IH 7 UBA ❑N/A
Adj.Wtr. BodySf kA r^? 5.. ...I t1 na /i
PWS: ❑FC: //��
yes no PNA yes /� Crit. Nab. yes / no Closest Maj.Wtr. Body Ps-L \IN/YV
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nber
1/Riprap length I
distance offshore I
x distance offshore
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ng permit may be required by: { ) L.3 Le-) Cl-, . See note on back regarding River Basin r

5406
ITINORI CONSTRUCTION BANK OFAMERICA
135 VIRGINIA LANE
SNEADS FERRY, NC 28460 66-19/530
[phone] 01•473,6
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- 1/44 5 2 e-kU. t- AUTHORIZED SI ATURE
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11■00540611. 1:053000 L961: 00065052 L99011'

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4.11AW-17. At , give authorization to
Antinori Marine Nnstruction to act as the
contracting agent in obtaining and signing for the
requested CAMA permit.
Job site address is:
I-12
My permanent address is:
(4(2I fp!- 6r; Ar- Lo
MrlkoroLtsk 14014 ,
©/ 75z
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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Sig -truer ,
item 4 if Restricted Delivery is desired. El Agent
• Print your name and address on the reverse X 0 Addressee
so that we can return the card to you. ed b - tedName)t C. Date of Delivery■ Attach this card to the back of the mailpiece, r.or on the front if space permits. vRecet, -' $1? Sp //
1. Article Addressed to: D. Is delivery address. ,• e •NIes
If YES,enter delive -,.•:sabeI w: ■ •
Yh c- fi sm t S z
5 3 1 .3 matvcrowQr C` . G S .��a
IlidlicPtih C 3. Service Type '�a �,
a t� CertifiedMall
Registered um Receipt for Merchandise
0 Insured Mail 0
C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7004 2890 0003 7344 4498
(Transfer from servlc
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540