43252D - Martin

iCAMA/ Li DREDGE & FILL / _ -
3ENERAL PERMIT Previous permit#
.New . Modification C(Complete 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 -)
$Rules attached.
t Name 1 r- Y:\I) }-\12)�L IQ Project Location: County 6 )S L c,..---'
I c.c L I IN W (L rye it L,-,L C C. 2.1 Street Address/State Road/Lot#(s)
-i,.5 K= L. i-• A t-`\ State 0 Cr ZIP L3L'I L'O I(oL I IVtom n.r V-1,v 6-4.... '{D,Lc T
( ) Fax#( ) Subdivision 0,g iA.-La N.) &P.
ed Agent r)g7i. rL L. iA)kt2--11.)s. G-=,Nsl . City 0• 1 PAL e A-k ZIPZ-t-1�t,
Cw LAW ❑PTA XES ❑PTS Phone# ( ) River Basin W+-I j e
OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body_ rr? Sw.� CI'''A`\(nat A
PWS: ❑FC:
yes do* PNA no Crit.Hab. yes / no Closest Maj.Wtr. Body �L w
Project/Activity -)3i C L_ stJ�e,vv t�vN-\ s.2-�, -.- S' \`j X 2-,+- C A a)
r.."/ A711 vki• L.A--)/ Ca.. •?O ' WI ►)& t. )+al_4..3 (Scale:
ck)length _
ier(s)
I F _ } - - ,
ngth I ' I _
Tiber
— -- L—
7 Riprap length
:distance offshore
x distance offshore
cannel
(i.....,N\j tik L. ------__
)ic yards
,plD ( 5D'
se/Boatlift k Id 4 I
t
JIldozing
v, APP�r•1c;i
i
10 x t 5
Length1 P II
of s yes no . \
s: not sure yes (,: ow \,
ium: n/a yes 4Z,
yes
lttached: yes _._._.__ -__-__
ig permit may be required by: �1L��� oP S�� C. �C Ac�� See note on back regarding River Basin rn

DIVISION OF COASTAL MANAGEMENT
ADJACENT RII'A►RIAN PROPERTY OWNER NOTIFICATIpwwAIVER F RM
ame of Individual Applying For Permit QZ - /?E. 9-
ddress of Property_ /G4/ /NZ Ei ,V'
(Lot or Street#, Street or Road)
%;c / zgE'? /SI G --/2/USL'''iv e'<
(My and Coady)
iereby certify that I own property adjacent to the above-referenced property. The individual
dying far this permit has described to me as shown on the attached drawing the development they
proposing A description or drawing with dimensions, should be provided with this letter.
• I have no objections to this proposaL
rou have objections to what is being proposed, please write the Division of Coastal
nagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or caIl910-395-3900
kin 10 days of receipt of this notice. No response is considered-the same as no objection if
have been notified by Certified Mal,
WAIVER SECTION
derstand that a pier,dock, mooring pilings, breakwater, boat house or boat lift must be
ick a minimum distance of 15'from my area of riparian access-unless waived by me. (If
wish to waive the setback,you must initial the appropriate blank below.)
v abfr
- I do wish to waive the 15'setback
I do not wish to waive the 15'setback 1
?-/anif (/e7X--
Date Ge./, /, • 5 ��' ,Q

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ANTINORI CONSTRUCTION BANK OFAMERICA 5046
135 VIRGINIA LANE
SNEADS FERRY, NC 28460 66-19/530
[phone] 7 pE- /
PAY TO THE ^/
ORDER OF !Y- C• 0 . F. _ a
$ 3cxo.o�
if-- f'lD i r i IO
jeC) DOLLARS
8
/621?"6".. ..„7/7"
MEMO AU OR�I ATURE
000501160 1:0 5 3000 L 9 6i: 000 6 50 5 2 L 9 9011■