46190D - Prince

b
CAMA/ 111 DREDGE & FILL _ '
3ENERAL PERMIT Previous permit#
*few 'Modification iComplete Reissue -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 5A NCAC -1 H • I Z_''
Rules attached.
it Name 4ad2'0 ?(ZZ,)C,Z.: Project Location: County r�J 1Thc 17.
0 Z-O .p,E-CL.(L`I V, aD .1 Street Address/State Road/Lot#(s)
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:ed Agent J'\i a- as_ City Su.fL t G: 1` / ZIP Z` -1 y,
ElCW [5EW ETA ❑ES ElPTS Phone# ( ) RiverBasir{ r
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❑PWS: ❑FC: _
yes PNA (/ no Crit. Hab. yes / no Closest Maj.Wtr. Body
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5808 .
Bank of America.
ANTINORI CONSTRUCTION
135 VIRGINIA LANE 530
SNEADS FERRY, NC 28460 66 19/ oZ q D,t c q �
[phone]
,�7�
PAY THE
ORDER OF N. C . D. r /• Q $ 00 • w
/Y �`
Q�/)t7 DOLLARS
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// // C A ED SI ATURE
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000 580811' 1:0 5 : 0006 50 5 2 L 99011'
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i 15 05 09: 47a p, 3
I, Da v f 0 c. e%i N cG , 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:
3 10 G 7T c' teo
� r �� � N �
S � y
My permanent address is:
Sao c �
JoLo GI) €Ietiy
4) 0 /11

�nn�IQN OF GOAST
ne of Individual Applying For Permit:
r�
L 77L �"� iN s7o�' ��o� �
dress of Property: �._5 n 1
(Lot or Street#, Street or Road)
/
(city and County)
ierebycertify that I own property adjacent to the above-referenced aw n pt davThe individual
they
plying for this permit has described to me���on
attached
be provided with this letter.
e pro o A description or drawing,
I have no objections to this proposal.
l
r you have objections to what is being proposed, ease write the Division of Coastal
please on, NC 28405 or call 910-395-3900
lanagement, 127 Cardinal Drive Extension, ou m��considered the same as no objection if
vithin 10 days of receipt of this notice. No response
you have been notified by Certified Mail.
[understand that a pier, dock, mooring pilings, breakwater, boat
house or boat- es waived ft my ust be
set bck a minimum distance of 15' from my area of riparian access
(If
you wish to waive the setback,you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
•
Z�Q wish to waive the 15' setback requirement.
This pier will not be within 15 feet of any other
property 1 ins. VOZ I toC
Sign Name
Date

DJVI,SIQN OF COASTAL MANAGEMENT
WJACENT_RIPARIAN PROPERTY OWNERNOTIFICATIQN/WAIVER FORM
of Individual Applying For Permit: i/i 1t a Vt.-C,
;s of Property:
(Lot or Street#, Street or Road)
(City and County) _
by certify that I own property adjacent to the above-referenced property. Tho individual
ng for this permit has described to me as shown on the attached drawing the development they
Dposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
a have objections to what is being proposed, please write the Division of Coastal
'gement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
a 10 days of receipt of this notice. No response is considered the same as no objection if
ave been notified by Certified Mall.
WAIVER
lerstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
:k a minimum distance of 15' from my area of riparian access-unless waived by me. (If
vish to waive the setback,you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
/ I do not wish to waive the 15' setback requirement.
This pier will notes be within 15 feet of any other
property 1 ine.
Name Date
ate