86193A - Immordino, Richard

&[r CAMA ❑ DREDGE & FILL n (ice Na 86193 & B C D
GENERAL PERMIT V Previous permit
Date previous permit issued
[� New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC �� + f �" ❑Rules attached. �' General Permit Rules available at the following link: www.deq.nc.Qov/CAMArules
i �
Applicant Name A I G,6 ar +
Address l �p J S + d e
City c; i State ►J zip -? 1-5 V
Phone # (� )
Email
Affected ❑ CW
AEC(s): ❑ OEA
ORW: yes/,no
Type of Project/ Activity
I
Shoreline Length
Access Length 2
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
EW ❑ PTA
IHA ❑ UW
PNA: yes/no
ES ❑ PTS
❑ SPIMA ❑ PWS
/ 'P 6 � <
�I o1,-fc
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift % Z-
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
/a f -r
Authorized Agent C:7�e r I ��!
r
Project Location (County):
Street Address/State Road/Lot #(s)
/Q.
Subdivision i A M o �1 '
City fkc�- zip
Adj. Wtr. Body
Closest Maj. Wtr. Body
nat/man/unk)
(Scale: )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit" Signature
7
Application Feels) Check #/Money Order Issuing Date Expiration Date

16x16 DECK
10-000 LB
LIFT - - - - ------------
4XX X4
LOWER DECK
6XI09 FT PIER --
6x32 FT RAMP

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to
(Name of Property Owner)
property located at 1 ��,�,��� , , , L v �
(Address, Lot, Block, Road, etc.)
on in ��+1U`'v�CL�.� N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
ntio .
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (If you wish 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.
(Property OwRep-Information) (A 'acent rope er information)
Signal Suit 1.�,
Print or Type Name Priyp4o,r a Name
x IZ� ) I QZ A laa
Mailing dr4sss , r� ��. M il' g Ad ress
City/State/Zip ��' i. T— City/ at i
113� �77-����� �
Telephone Numb r/email address Te/ep7lohe Number email address
& l > -% IV9121
Dale Dale"
(Revised Aug. 2014)
"Valid for one calendar year after signature'

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _ f <i'c; L, rh Iv, 5 i• 1 i 0 ,s
(Name of Property Owner)
property located at — i ;�j
f r (Address, Lot, Block, Road etc.)
on 1, t G ��u�,t�'! 1 Q �. J , in Ers i �; r : ; (om. /'� Cc�,(wf- ,, 1 AJI C)
(Waterbody) (City/Town ant!/or County) J
The applicant has described to me, as shown
location.
below, the development proposed at the above
1 have no objection to this proposal. (as dc: .��c r
1 have objections to this ro l 2-pp)
DESCRIPTION AND/OR DRAWING Of PROPOSED DEVELOPMENT
(individual proposing developmentdtn h/tWsfrcripoow or atach a site drawing)
WAIVER SECTION....
I understand that a pier, dock, mooring pitings; boat ram, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (if you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
X" I do not wish to waive the 15' setback requirement. 6J2— ci,e-
.Signatzir .
r-#Qlt�0
Print or Type Na e
:r
Mailing A
City/State zip Z., — 9 77— 9W
Telephone Num er / mail ddress
/,Z/17
Date
1�-----
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Signature*
i�cl,�rc�
Print or Type Name
` 62c? 6th
Mailing Address -
�g A 2.� ofY
City/State
Telephone Number / email address
Pali'»
(Revised Aug_ 2014)

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address
Phone Number:
Email Address:
I certify that I have authorized
1bfz, S©G,�r�S�G L/1
ZAAlM0
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:b('o
at my property located at
in )) L.i_ County.
1 furthermore certify that l am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
_ Signature
Print or Type Name
Z2U✓Ut7
Title
/ 2 I I / Zo L(
Date
This certification is valid through 3 1 1 / ­2 Z

This map is prepared
from data used for the 106 Soundside LN
DAwills.
inventory of the real Manteo NC, 27954
property for taxParce1:025206000
purposes. Primary
information sources such Pin: 987010269771
as recorded deeds, plats,
and other primary
public records should be
consulted for verificationof the information
a _ e
i� RIF
' a
AIL-
Owners: Immordino, Dante P -
Secondary Owner
Building Value: $246,200
Land Value: $354,300
Misc Value: $20,300
Total Value: $620,800
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Tax District: Manteo Out
Subdivision: Louis A Mauro Jr
Lot BLK-Sec: Lot: Blk: Sec:
Property Use: Residential
Building Type: Traditional
Year Built: 1986

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