19970357 Ver 1_Complete File_19970505

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Coastal Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Roger N. Schecter, Director
MEMORANDUM:
TO:
FROM:
SUBJECT:
Applicant:
�dCEJVED
BY:
April 22, 1997
Mr. A. Preston Howard, P.E., Director
Division of Water Quality
John R. Parker, Jr.
Major Permits Processing Coordinator
() 5,54
EDEHNR
CAMA /DREDGE & FILL Permit Application Review
Sea Level Ventures, LLC
Project Location: Hwy. 70 E, Nelson Bay, Carteret County
Proposed Project: to expand an existing pier to allow for 10 boat slips
I �
Please indicate below your office's position or viewpoint on the proposed project and return this
form by May 13, 1997. If you have any questions regarding the proposed project, please contact
Charles Pigott at (919) 808 -2808. When appropriate, in -depth comments with supporting data is
requested.
REPLY:
VV
5M91
office has no objection to the project as proposed.
This office has no comment on the proposed project.
This office approves of the project only if the recommended changes are
incorporated. See attached.
This office objects to the project for reasons described in the attached
comments.
SIGNED n,("(- Q`_ (� t--) l tp -- r-- DATE � — � — q ­-)
bawl
Hestron Plaza II, 151 B, Highway 24, Morehead City NC 28557 N�� C An Equal Opportunity / Afflrmative Action Employer
Volce 919 - 808 -2808 FAX 919 - 247 -3330 Courier 11 -12- 09 50% recycled/ 10% post- consumer paper

`A
DIVISION OF COASTAL MANAGEMENT
FIELD INVESTIGATION REPORT
1. APPLICANT'S NAME: Sea Level Ventures, LLC
2. LOCATION OF PROJECT SITE: Nelson Bay Hwy 70E, Sea Level, Carteret County
Photo Index - 1989: 148 -18 U -19 1984: 152 -360 U -21 1995: 53 -624 D -11
State Plane Coordinates - X: 2782400 Y: 420600
3. INVESTIGATION TYPE: CAMA only
4. INVESTIGATIVE PROCEDURE: Dates of Site Visit - February 21, 1997
Was Applicant Present - yes
5. PROCESSING PROCEDURE: Application Received - March 21, 1997, Revised April 15, 1997
Office - Morehead City
6. SITE DESCRIPTION:
(A) Local Land Use Plan - Carteret County
Land Classification From LUP - Community /Conservation
(B) AEC(s) Involved: PTA, EW
Water Dependent: yes
(D) Intended Use: commercial
(E) Wastewater Treatment: Existing - septic tanks
Planned -none
(F) Type of Structures: Existing - 25 unit condominium, restaurant, pier and bulkhead
Planned - 10 slips
(G) Estimated Annual Rate of Erosion: minimal
Source - observed
7. HABITAT DESCRIPTION: [AREA]
DREDGED FILLED OTHFR
(A) Vegetated Wetlands
none
(B) Non - Vegetated Wetlands
Open Water (pier footprint)
9,700 sq. ft.
® Other
none
(D) Total Area Disturbed: 9,700 sq. ft.
(E) Primary Nursery Area: No
(F) Water Classification: SC Open: No
8. PROJECT SUMMARY: The applicant plans to expand an existing pier to allow for 10 boat slips.

IA
FIELD INVESTIGATION REPORT:
SEA LEVEL VENTURES, LLC /CARTERET
PAGE #2
9. NARRATIVIE DENCRIPTIQ N: The applicant's property is located on a 5 acre tract of
land adjacent to Hwy 70E and Nelson Bay in the small community of Sea Level,
Carteret County. The property is located at the site of the former Sea Level Inn Motel
and Restaurant. The present owners have purchased this property and converted the
motel into a 25 unit condominium. The area of shoreline behind the condominiums and
restaurant have been stabilized by a wooden bulkhead. The previous owners constructed
a pier, 310' long x 8' wide, with a "T° at the waterward end (measuring 110' long x 8'
wide) on the property several years ago. A few years ago, 4 mooring pilings were
placed approx. 60' to the east of the existing pier to accommodate the Sea Level
Volunteer Fire And Rescue Boat. These pilings were installed without a permit which
resulted in a Notice of Violation being issued to Sea Level Fire and Rescue Department,
however, no restoration was required. The waters of Nelson Bay at the project site have
been classified as SC and are closed to the harvesting of shellfish for human
consumption. There are areas of submerged aquatic vegetation adjacent to the project
site.
The applicant is now proposing to construct 4 finger piers, each measuring 10' long x 3'
wide, with associated mooring pilings to accommodate 10�boat• slips. The existing 4
mooring pilings would be pulled up during the construction phase of the new addition.
According to the applicant's plat water depths at the end of the existing pier would be -
6.5' at Mean Low Water. No dredging or other improvements are proposed at the site
at the present time.
10. ANTICIPATED ENIPACTS: The applicant is proposing to add 4 finger piers
and 14 mooring pilings which will provide 10 slips at an existing pier. The mooring
area used by the Fire and Rescue Boat would be abandoned and the pilings pulled out.
The proposed slips, the existing pier and "T" section will result in approx. 10,000 sq. ft
of Public Trust Area and Estuarine Waters being shaded by this docking facility. Some
short term increase in turbidity would be expected during pile driving. All portions of
the pier and proposed improvements would be 400' plus from either property line.
Prepared by: Charles O. Pigott
Date: April 16, 1997

s
Form DCM -MP -1
APPLICATIO
(To be completed by all applicants)
1. APPLICANT
a. Landowner:
Name - SE�i lztlf VIFIV GO/ —Ir s' •PLC
Address _ d - 9&x, % 7
City S" ,LE (DEL State V- C •
Zip 2 ff•-77 Day Phone 919 ,Z7S =42/2
Fax g/q -122S -- 17DCF
b. Authorized Agent:
Name 6-. �?yTCH Z17f
Address /,� Q ZOV, 97
City S44 .IEyEL State C
Zip Z,::Ef77 Day Phone 919.22 -S =/1/2
Fax 9/9 -22J= 17eP
c. Project name (if any)
Co /V,0,0 M iiYlairl
NOTE. Permit will be issued in name of k vufownerfs), and /or
project name.
2. LOCATION OF PROPOSED
PROJECT
a. County CArlSX F7'
Revised 03/95
b. City, town, community or landmark
C. Street address or secondary road number
d. Is proposed work within. city limits or planning
jurisdiction? Yes Y_ No
e. Name of body of water nearest project (e.g. river,
creek, sound, bay) ' /V6 L So,Vs ' A,Ay
3. DESCRIPTION AND PLANNED USE
OF PROPOSED PROJECT
a. List all development activities you propose (e.g.
building a home, motel, marina, bulkhead, pier, and
excavation and /or filling activities.
12V57VIL 10daiP1•�/�
b. Is the proposed activity maintenance of an existing
project, new work, or both? /WAI kai1'i{'
c. Will the project be for public, private or commercial
use? P/4 /U,dTC
d. Give a'brief description of purpose, use, methods of
construction and daily operations of proposed
project. If more space is needed, please attach
additional pages.
- 45alL D /o &0,47-
'41 !LD y 1 -5,0 � P/�xs
�n o id-r- o t✓`YG�t'S To

Form DCM -MP -1
r- •- ,•- ,'.. -.. ,-� qty. ``
;4. LAND AND. WATER
CHARACTERISTICS
a. Size of entire tcacf 34 ,4C
b. Size of individual lot(s)
c. Approximate elevation of tract above MHW or
NWL SE,' 1A AXT
d. Soil type(s) and texture(s)-of tract
CO ALA - 14R46dN lA1V4 CaM)fjgY
e. Vegetation on tract S6,ME OgusT
f. Man-made features now on tract
6,#,06s
g. What is the CAMA Land Use Plan land
classification of the site? (Consult the iocai land use plan.)
Conservation Transitional
Developed Community _ Rural Other
h. How is the tract zoned by local government?
/ 6lyr— zewgo
i. Is the proposed project consistent with the applicable
zoning? Yes No ,Y /,a
(Attach Zoning compliance certiicaiq, if applicable)
j•
Has a professional archaeological
done for the tract? Yes
If yes, by whom?
assessment been
X No
k. Is the project located in a National gegistered
Historic District or does it involve a National
Register listed or eligible property?
Yes Y No
1. Are there wetlands on the site? Yes -Y-- No
Coastal (marsh) X Other
If yes, has a delineation been conducted?
(Attach documentation, if available)
m. Describe existing wastewater treatment facilities.
n. Describe location and type of discharges to waters
of the state. (For example, surface runoff, sanitary
wastewater, industrial /commercial effluent, "wash
down" and residential discharges,)
N045
o. Describe existing drinking water supply source.
5. ADDITIONAL INFORMATION
In addition to the completed application form, the
following items must be submitted: -
• A copy of the deed (with state application only) or
other instrument under which the applicant claims title
to the affected properties. If the applicant is not
claiming to be the owner of said property, then
forward .a copy of the deed or other instrument under
which the owner claims title, plus written permission
from the owner to carry out the project.
• An accurate, dated work plat (including plan view
and cross- sectional drawings) drawn to scale in black
ink on 'an •8 1/2" by 11" white paper. (Refer to
Coastal Resources 'Commission Rule 7J.0203 for a
detailed description.)
Please note that original drawings are preferred and
only high quality copies will be accepted. Blue -line
prints or other larger plats are acceptable only if an
adequate number of quality copies are provided by
applicant. (Contact the U.S. Army Corps of
Engineers regarding that agency's use of larger
drawings.) A site or location map is a part of plat
requirements and it must be sufficiently detailed to
guide agency personnel unfamiliar with the area to the

Form DCM -MP -1
site. Include highway or secondary road (SR)
numbers, landmarks, and the like.
• A Stormwater Certification, if one is necessary.
• A list of the names and complete addresses of the
adjacent waterfront (riparian) landowners and
signed return receipts as proof that such owners
have received a copy of the application and plats
by certified mail. Such landowners must be advised
that they have 30 days in which to submit comments
on the proposed project to the Division of Coastal
Management. Upon signing this form, the applicant
further certifies that such notice has been provided.
Ali
u AP R 1 5 1997
6. CERTIFIL=ONI AND- TERMISSION
TO ENTER ON LAND
I understand that any permit issued in response to this
application will allow only the development described in
the application. The project will be subject to conditions
and restrictions contained in the permit.
I certify that to the best of my knowledge, the proposed
activity complies with the State of North Carolina's
approved Coastal Management Program and will be
conducted in a manner consistent with such program.
Name �G1 �f'� d/,ylil. ,�77J/.- q'EFF P4 /7&? I certify that I am authorized to grant, and do in fact,
Address
0.2
6A9 4�N .Si:. ,914gh
hi iY.0 • grant permission to representatives of state and federal
Phone
919-
WIIIFV- GS�
-2776-5 review agencies to enter on the aforementioned lands in
DCM MP-6
Marina Development
connection with evaluating information related to this
Name
5�,�
L��/F� /r}'.G ,Q�SC'ti�.
GaM•�r. permit application and follow -up monitoring of the
Address
5,9,4
1—EUEI. , A/_C
Zd-'s77 project.
Phone
9'/9-
Z2 r 772/
Name
Address
Phone
• A list of previous state or federal permits issued for
work on the project tract. Include permit numbers,
permittee, and issuing dates.
• A check for $250 made payable to the Department of
Environment, Health, and Natural Resources
(DEHNR) to cover the costs of processing the
application.
• A signed AEC hazard notice for projects in
oceanfront and inlet areas.
• A statement of compliance with the N.C.
Environmental Policy Act (N.C.G.S. 113A - 1 to
10) If the project involves the expenditure of public
funds or use of public lands, attach a statement
documenting compliance with the North Carolina
Environmental Policy Act.
I further certify that the information provided in this
application is trithful.to the best of my knowledge. __
This is the 1'1'5 day of ,41 /L , 19.07.
It I
Print Name z5 ff6170'1 64 AdS` ,. X
r
Signature
Landowner or Auzhomed .!gent
Please indicate attachments pertaining to your proposed
project.
DCM MP -2
Excavation and Fill Information
DCM MP -3
Upland Development
DCM MP-4
Structures Information
DCM MP -5
Bridges and Culverts
DCM MP-6
Marina Development
NOTE. Please sign and date each attachment in the
space provided at the bottom of each form.

Form DCM -MP4
STRUCTURES
(Construction within Public Trust Areas)
Attach this form to Joint Application for CAMA Major
Permit, Form DCM -MP -1. Be sure to complete all
other sections of the Joint Application which relate to
this proposed project.
a. Dock(s) and /or Ej=W
(1) _ Commercial _Community Y Private
(2) Number
(3) Length '
(4) Width
(5) F_ inger Piers X Yes No
(i) Number -*71
(ii) Length /d
(iii) Width _7
(6) Platform(s) Yes No
(i) Number
(ii) Length
(iii) Width
(7) Number of slips proposed �4
(8) Proximity of structure to adjacent riparian
property lines _ 3S f`I �Q 9 &,4ra
(9) Width of water body / iN /LE * —
(10) Water depth at waterward end of pier at
MLW or NWL 6 -.S�
b. , Boathouse (including covered lifts) NIA
(1) Commercial Private
(2) Length r
(3) Width
c. Groin (e.g. wood, sheetpile, etc.)
(1) Number
(2) Length(s)
d. Breakwater (e.g
(1) Length
(2) Average
wetlands _
(3) Maximum
wetlands
A//ti
wood, sheetpile, etc.) A'/ /A-
distance from MHW, NWL or
distance beyond MHW, NWL or
ff 11�. 1.1�' J 1 51997
e. Mooring buoys /V
(1) _ Comme cial _Community _ Private
(2) Number
(3) Description of buoy
(Color, inscription, size, anchor, etc.)
(4) Width of water body
(5) Distance buoy(s) to be placed beyond
shoreline
f. Mooring structure (boatlift, mooring pilings, etc.)
(1) _ Commercial _Community _ Private
(2) Number /4V
(3) Length 1/0
(4) Width /6
g. Other (Give complete description)
— &r'iyt a /,a S/ '1�IL/W3, .9s
/Yd TEd oiY 44.4 P
5,04 .LGUEL l/�iyTGI.�ES, L.l C
Applicant or Project ame
6•
Signature
Date

DIVISION OF COASTAL MANAGEMENT
FIELD INVESTIGATION REPORT
1. APPLICANT'S NAME: Sea Level Ventures, LLC
I ohs--,
2. LOCATION OF PROJECT SITE: Nelson Bay Hwy 70E, Sea Level, Carteret County
Photo Index - 1989: 148 -18 U -19 1984: 152 -360 U -21 1995: 53 -624 D -11
State Plane Coordinates - X: 2782400 Y: 420600
3. INVESTIGATION TYPE: CAMA only
4. INVESTIGATIVE PROCEDURE: Dates of Site Visit - February 21, 1997
Was Applicant Present - yes
oti d FO
5. PROCESSING PROCEDURE: Application Received - March 21, 1997, Revised April 15, 1997
Office - Morehead City
6. SITE DESCRIPTION:
(A) Local Land Use Plan - Carteret County
Land Classification From LUP Community /Conservation
(B) AEC(s) Involved: PTA, EW.
Water Dependent: yes
(D) Intended Use: commercial
(E) Wastewater Treatment: Existing - septic tanks
Planned -none
(F) Type of Structures: Existing - 25 unit condominium, restaurant, pier and bulkhead
Planned - 10 slips
(G) Estimated Annual Rate of Erosion: minimal
Source - observed
7. HABITAT DESCRIPTION:
[AREA]
T)RFnr-.FT) FTT,T,FT) 0THF,R
(A) Vegetated Wetlands
none
(B) Non - Vegetated Wetlands
Open Water (pier footprint)
9,700 s . ft.
® Other
none
(D) Total Area Disturbed: 9,700 sq. ft.
(E) Primary Nursery Area: No
(F) Water Classification: SC Open: No
8. PROJECT SUMMARY: The applicant plans to expand an existing pier to allow for 10 boat slips.

r
FIELD INVESTIGATION REPORT:
_ -SEA LEVEL VENTURES, LLC /CARTERET
PAGE #2
9. NARRATIV , D S .RIPTION: The applicant's property is located on a 5 acre tract of
land adjacent to Hwy 70E and Nelson Bay in the small community of Sea Level,
Carteret County. The property is located at the site of the former Sea Level Inn Motel
and Restaurant. The present owners have purchased this property and converted the
motel into a 25 unit condominium. The area of shoreline behind the condominiums and
restaurant have been stabilized by a wooden bulkhead. The previous owners constructed
a pier, 310' long x 8' wide, with a "T" at the waterward end (measuring 110' long x 8'
wide) on the property several years ago. A few years ago, 4 mooring pilings were
placed approx 60' to the east of the existing pier to accommodate the Sea Level
Volunteer Fire And Rescue Boat. These pilings were installed without a permit which
resulted in a Notice of Violation being issued to Sea Level Fire and Rescue Department,
however, no restoration was required. The waters of Nelson Bay at the project site have
been classified as SC_ and are closed to the harvesting of shellfish for human
consumption. There are areas of submerged aquatic vegetation adjacent to the project
site.
The applicant is now proposing to construct 4 finger piers, each measuring 10' long x 3'
wide, with associated mooring pilings to accommodate 10 boat slips. The existing 4
mooring pilings would be pulled up during the construction phase of the new addition.
According to the applicant's plat water depths at the end of the existing pier would be -
6.5' at Mean Low Water. No dredging or other improvements are proposed at the site
at the present time.
10. ANTICIPATED IMPACTS: The applicant is proposing to add 4 finger piers
and 14 mooring pilings which will provide 10 slips at an existing pier. The mooring
area used by the Fire and Rescue Boat would be abandoned and the pilings pulled out.
The proposed slips, the existing pier and "T" section will result in approx. 10,000 sq. ft
of Public Trust Area and Estuarine Waters being shaded by this*docking facility. Some
short term increase in turbidity would be expected during pile driving. All portions of
the pier and proposed improvements would be 400' plus from either property line.
Prepared by: Charles O. Pigott
Date: April 16, 1907

Form DCM -MP -1
APPLICATIO
(To be completed by all applicants)
1. APPLICANT
a. Landowner:
Name 5,42 IZUfL .PLC
Address 7
City SF.4 Z.Al"0L State AI C-
Zip 2 ff.5-77 Day Phone 919 -Z2 =1.2X2
Fax 919 -.22,5-- 170cF
b. Authorized Agent:
Name E' . �.t�yrcy lr,Qit r .95- ate
Address /,� 4- .boy 97
City S" . 6P,-Z State -�I c
Zip .2597 Day Phone 9/9 •-?.ZS = / ?/Z
Fax 9/9 -22J= 17a,p
c. Project name (if any) 44WOZ
Co N D o.yr /iY!llivl
NOTE. Permit will be issued in name of landm mer(s), and /or
project name.
2. LOCATION OF PROPOSED
PROJECT
a. County 1! ,ACILW E T
Revised 03/95
b. City, town, community or landmark
c. Street address or secondary road number
f-Iw Y 70 -
d. Is proposed work within city limits or planning
jurisdiction? ' ' Yes Y No
e. Name of body of water nearest project (e.g. river,
creek, sound, bay) NE Z Says ' 'my
3. DESCRIPTION AND PLANNED USE
OF PROPOSED PROJECT
a. List all development activities you propose (e.g.
building a home, motel, marina, bulkhead, pier, and
excavation and /or filling activities.
11 LL A Do/l%Rd- A -W-5, 149'e
/o &4.471 Awo �lWj
b. Is the proposed activity maintenance of an existing
project, new work, or both? IWAI
c. Will the project be for public, private or commercial
use? Plf IU,47,C-
:4
d. Give a brief description of purpose, use, methods of
construction and daily operations of proposed
project. If more space is needed, please attach
additional pages.
1fG1/LD /D
_ AL,'", (1 Q CUN,�e M /,�d6tti41
tali 140 �/ �i�✓�r -,� 1'/�.�5
)570)t 150 /�T O �✓�YGit'S To

Form DCM -MP -1
J. LAND .AND- WATER
CHARACTERISTICS
a. Size of entire tract 34 4C
b. Size of individual lot(s) _ �Z
c. Approximate elevation of tract above MHW or
NWL S51' 111f;V5,
d. Soil type(s) and texture(s) of tract
s_ 3,0 R nor r a /wc- sA, "
e. Vegetation on tract .56m e " ,#SS
f. Man-made features now on tract ICIER
/VlJ C D'#.96 —57, 1465­j-,4ttlP.01vT
g. What is the CAMA Land Use Plan land
classification of the site? (Consult the local land use plan.)
Conservation Transitional
Developed Community
-,Y Rural r4 Other
h. How is.the tract zoned by local government?
IY61KC ZGNh/i
i. Is the proposed project consistent with the applicable
zoning? Yes No IYI'A
(Attach zoning compliance cerdf ficatq, if applicable)
j•
Has a professional
done for the tract?
If yes, by whom? -
archaeological assessment been
Yes X No
k. Is the project located in a National Jtegistered
Historic District or does it involve a National
Register listed or eligible -property? .,
Yes _X No
Are there wetlands on the site? Yes ) No
Coastal (marsh) _X Other
If yes, has a delineation been conducted?
(Attach doatntentation, if available)
Revised 03/95
m. Describe existing wastewater treatment facilities.
n. Describe location and type of discharges to waters
of the state. (For example, surface runoff, sanitary
wastewater, industrial /commercial effluent, "wash
down" and residential discharges.)
NdN9
o. Describe existing drinking water supply source.
5. ADDITIONAL INFORMATION
In addition to the completed application form, the
following items must be submitted:
• A copy of the deed (with state application only) or
other instrument under which the applicant claims title
to the affected properties. If the applicant is not
claiming to be the owner of said property, then
forward .a copy of the deed or other instrument under
which the owner claims title, plus written permission
from the owner to carry out the project.
• An accurate, dated work plat (including plan view
and cross-sectional drawings) drawn to scale in black
ink on an 8 1/2' by 11" white paper. (Refer to
Coastal Resources *Commission Rule 7J.0203 for a
detailed description.)
Please note that original drawings are preferred and
only high quality copies will be accepted. BIue -line
prints or other larger plats are acceptable only if an
adequate number of quality copies are provided by
applicant. (Contact the U.S. Army Corps of
Engineers regarding that agency's use of larger
drawings.) A site or location map is a part of plat
requirements and it must be sufficiently detailed to
guide agency personnel. unfamiliar with the area to the

Form DCM -MP-4
STRUCTURES
(Construction within Public Trust Areas)
Attach this form to Joint Application for CAMA Major
Permit, Form DCM -MP -1. Be sure to complete all
other sections of the Joint Application which relate to
this proposed project.
a. Dock(s) and /or P'
(1)
_ Commercial _Community Y Private
(2)
Number
(3)
Length
(4)
Width 'X"
(5)
F_ inger Piers X Yes No
d. Breakwater (e.g. wood, sheetpile, etc.)
(i) Number -V
Length
(ii) Length /d
Average distance from MHW, NWL or
(iii) Width —?
(6)
Platform(§) Yes No
Maximum distance beyond MHW, NWL or
(i) Number
wetlands
(ii) Length
(iii) Width
(7)
Number of slips proposed /4
(8)
Proximity of structure to adjacent riparian
property lines �-S . IrRG�•dT
(9)
Width of water body / tiI45 t
(10)
Water depth at waterward end of pier at
MLW or NWL 6 --5
b. Boathouse (including covered lifts) /JL
Rpv;rpd nzmc
(1)
Commercial Private
(2)
Length _
(3)
Width
c. Groin (e.g. wood, sheetpile, etc.)
(1)
Number
(2)
Length(s)
d. Breakwater (e.g. wood, sheetpile, etc.)
(1)
Length
(2)
Average distance from MHW, NWL or
wetlands
(3)
Maximum distance beyond MHW, NWL or
wetlands
0 4?a 1 5 ;7
e. Mooring buoys N
(1) _ Comme cia)l _Community _ Private
(2) Number
(3) Description of buoy
(Color, inscription, size, anchor, etc.)
(4) Width of water body
(5) Distance buoy(s) to be placed beyond
shoreline
f. Mooring structure (boatlift, mooring pilings, etc.)
(1) _ Commercial _Community _ Private
(2) Number /IV
(3) Length YO
(4) Width 16
g. Other (Give complete description)
i1x V AIL /rY�S .V S
/Ya 760 oiY /H 4 P
5 ,0.d ,LGyXG 6/ L 7R'rae5- .l C
Applicant or Project;,, �fune
6•
Signature
Date

Form DCM -MP -1
site. Include highway or secondary road (SR)
numbers, landmarks, and the like.
• A Stormwater Certification, if one is necessary.
• A list of the names and complete addresses of the
adjacent waterfront (riparian) landowners and
signed return receipts as proof that such owners
have received a copy of the application and plats
by certified mail. Such landowners must be advised
that they have 30 days in which to submit comments
on the proposed project to the Division of Coastal
Management. Upon signing this form, the applicant
further certifies that such notice has been provided.
Name S R fL 44olf• 47VY.
Address St Q-7, ORE d--d. Sr
Phone 91,
Name
Address 5,9A 'ILEUEG
Phone 9'/9- 2 r 7721
Name
Address
Phone
APR 1 51�J Ii
U
6. CERTIFICA"IZQp`"A1VD"PERMISSION
TO ENTER ON LAND
I understand that any permit issued in response to this
application will allow only the development described in
the application. The project will be subject to conditions
and restrictions contained in the permit.
I certify that to the best of my knowledge, the proposed
activity complies with the State of North Carolina's
approved Coastal Management Program and will be
conducted in a manner consistent with such program.
U'EFF P47E1? I certify that I am authorized to grant, and do in fact,
91 hj � - grant permission to representatives of state and federal
review agencies to enter on the aforementioned lands in
connection with evaluating information related to this
permit application and follow -up monitoring of the
20:J -77 project.
• A list of previous state or federal permits issued for
work on the project tract. Include permit numbers,
permittee, and issuing dates.
• A check for $250 made payable to the Department of
Environment, Health, and Natural Resources
(DEHNR) to cover the costs of processing the
application.
• A signed AEC hazard notice for projects in
oceanfront and inlet areas.
• A statement of compliance with the N.C.
Environmental Policy Act (N.C.G.S. 113A - 1 to
10) If the project involves the expenditure of public
funds or use of public lands, attach a statement
documenting compliance with the North Carolina
Environmental Policy Act.
Revised 03/95
I further certify that the information provided in this
application is truthful to the best of my knowledge.
This is the .?5 day of I / L , 19 Q 7.
,I I
Print Name 1_1#7e l-1 Sr f 14 &T
Signature
Landowner or Awt ,.&d Agent
Please indicate attachments pertaining to your proposed
project.
DCM MP -2
Excavation and Fill Information
DCM MP -3
Upland Development
DCM MP-4
Structures Information
DCM MP -5
Bridges and Culverts
DCM MP-6
Marina Development
NOTE: Please sign and date each attachment in the
space provided at the bottom of each form.

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