42454_CDJM INVESTMENTS_20050819

L::./p►MA / DREDGE &FILL
t n 5 4-
GENERAL PERMIT
Previous permi
D'New Modification ❑Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant
to (SA NCAC
Rules attached.
Applicant Name _ C D 7
Project Location: County
Address
Street Address/ State Road( Lot #(s)
City �i '�.;: �F.-+� State `}'"�` ZIP
Phone # Fax # O
Subdivision
Authorized Agent
City + ' ZIP
CW EW i PTA- *DES ❑PTS
Affected
Phone # (_ _) f' River Basin
OEA HHIF IH ❑ USA El N/A AEC(s):
Adj. Wtr. Body � : � (nat /man /unkn
Pws. PC.�
_
ORW: yes j no PNA yes J no Crit. Hab. yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s) ; i r
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore
Basin, channel -
cubic yards
Boat ramp
Boathouse/ Boatlift I j
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes
no
Sandbags: not sure yes
tno
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
no —
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
. N,�
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: )
44
I
f
See note on back regarding River Basin rules.
/ f1L sit- .._�.G' r',✓t.s-,_�,�......-++�
Permit Officer's Signature
Issuing Date Expiration Date
Local Planning) urisdiction Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules I Other:
-1 Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: [phone]
Elizabeth Cif District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastaimanagement.net
Revised 10/05/01

! CAMA/ ❑DREDGE�
C& FILL, NO 4245
GENERAL- PEF��i IT reviouspermit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue ate previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
li L_(_ ❑ Rules attached.
Applicant Name C P -3 � 1my,! �1�►�'ie•�✓ TS Project Location: County 64&
Address 8 9L90 94a Street Address/ State Road/ Lot #(s) /� -rr
City 1AJ 111 rn f Aq � State G _ ZIP S �/ s!o ©(o —T5 la --a 9d --
Phone # (IM) a��"D1f12 Fax # (_) Subdivision
Authorized Agent _ �� nP� City �G tr 4`, �0�-1- ��i ZIP
❑ Cw W (/ TTA V ❑ ES ElPTS Phone # (gffl `�1 River Basin Ill
Affected 0 OEA ElHHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body 25fIGgS0&A1d _._-- nat,Yman /unkn)
❑ Pws: o Fc:
Closest Maj. Wtr. Body
ORW: / no PNA yes / � Crit. Hab, yes / no yes
Type of Project/ Activity �rG-zj�Yltc� / g 7i/ Cc GL�'js `f d ct' ---
�, 2. L.. i5 (Scale: N TS )
Pier (dock) length
) 116 $ 701j1y —
Platform(s) �rb p6 pvC-
Finger piers)
Groin length e j (i. , j~ L 1r�
number Bulkhead/ faiPraP length
h _-- - - ,' t 3 • I � � . ©1_� J - -
avg distance offshore
max distance offshore Ci
Basin, channel--� -
— - -
t �
cubic yards D
Boat ramp / / �]� j - -• _
Boat ous i oa
>U H tJ
i
Beach Bulldozing
Other ;Vi
- - - -
I ,
t I
Shoreline Length
SAV: not sure yes 6&— - - - --- j —
Sandbags: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes �i -- ,,—/----I--- ---- ----- --- ------------ -----
A building permit may be required by: ���T� �`GT �� r ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions � A, Ore- '/4,2 -- CIO S A 9 � !'4V� � ��
e 15 / -�r' on , T i pa f- r ci,. �- do r r c cite
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit *'*
L. _- _-- —_ -
Permit Officer's ignature
y-/-7-0 '�
//--/9- (D�-
Issuing Date
Expiration Date
dhx'lerrel &.
LDV) /74
I ..�..1 PL.....,....l...i�.t:.ri..n
Rn..n� MO. N—

JONATHAN PATRICK JOYNER 1026
NCDL 7569312 !a?,)
/�.,M4 HORLANDALE DRIVE 0�,7 ss-1s/530 NC
WILMINGTON, NC 28411-9628 Date ___ so0os
Pay To The �� � _ ` $ cv C 0
Order Of /__—._
Y,�✓l�f/1 dl lL------- - Dollars
BankofAmerica
•iceAGH fi/T 053000790
ForcMA
-
i:053000 196i; 000MG 2 2 2 2GOO 1025

ffyTim,
��i'J�- - ' �_
HCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
August 19, 2005
CDJM Investments
C/o Jon Joyner
8500 Bald Eagle Lane
Wilmington, NC 28411
Dear Mr. Joyner::
Attached is General Permit #42454C
In order to validate this permit, please sign all three (3) copies as indicated. Retain the white
copy for your files and return the signed yellow and pink copies to us in the enclosed, self-
addressed envelope. If the signed permit copies are not returned to this office before the initiation
of development, you will be working without authorization and will be subject to a Notice of
Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely,
Tf O-Z N J-'Lb
Mark Hardeman/lsb
Coastal Management Representative
Enclosures
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper

Postal
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Postageg37 �
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p Certified Fee FU
p p Certified Fee
p Return Receipt FeePostmark p(EndorsementRequired)Here Return Receipt Fee $1.75
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Return Receipt Fee $1.75
(Endorsement Required)
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Total Postage & Fees $ p 06/30/2005
t17 Total Postage & Fees $ i4.42 06/30/2005 0 $ �4,42
.p Total Postage &Fees
p Sent To uy
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or PO box No. / �G C3 T� \ S v J n I p YeO Yin ✓' /1S/
City State, Zi. Q I t, J- S-IG -- � & 1 Street, Apt No.; — j� 3Yreef, ApG No.c —
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or PO Box No. `00 IN, N. OLD'n ��� i ��„ a 7D y or PO Box No. pQi �fjj�' l7
/��� r�Jc rs �s end � city. side,-ziP+a --2002 See Reverse for Instructions /-�--�------- ------------------------- ------------------------- ------
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r - '
6/ 16/05
DENR/CAMA
Mark Hardeman
Morehead City, NC 28557
Re: Dock permit for 606 Island Road, Harkers Island
Mr. Hardeman,
I've contracted to purchase the aforementioned lot. I request permission from
DENR/CAMA to build a 4 wide dock with 2 boat slips with electric lifts. I will adhere
to all CAMA regulations. I've attached. a survey competed on June 14t', 2005, the
receipts for certified mail delivery of notification letters to adjoining property owners
listed on the survey, a $100 check for you to perform an on site inspection. Please let me
know if you need any additional information. I can be reached at the number below.
If my request for a dock and boat lift permit is granted please issue the permit to the
company name below, and fax to 910-251-5229 and mail to:
CDJM Investments, LLC
8500 Bald Eagle Land
Wilmington, NC 28411
I'm set to purchase the property on July 17t' and want to have permission to build a dock
before I buy the lot.
Thanks for your assistance and please call if you have any questions.
Jon Joyner
910-262-0102 -
RIF SIVED
JUL O 12005
Morehead City DCM

JUN-28-2005 TUE 02:47 PM NC DIV OF COASTAL MGMNT FAX NO. 4
P. 02
tS.RrA(',EIV17 RCPAIZIAN PROPERTY OWNER STATErV'iENT
(TOR A PIER11VO.0RILVG PILINGSIROA7LlI•T/Bo.1 T110U,51;)
_ l UGC L i�~t awN��,
I herby rectify that I own property adjacent to A
�� ��
/ (\acne of Property Owner)
prolx rty lrxitc c at D g �s�`r� x.
�_. --- (i.o(, Mock, Road, etc.) '
vn N.C.
(t';/ate�-Uutiy) (rown and/or County)
fle itca-4 dcscribcd to me, as shown below, the development he is proposing at that location,
arrci, I have no objections to his proposal. I understand that a pier/mooring
pilinl;SJL,o;uliit/l,aatlrc�use must be set back a mirtimurn distance of fifteen feet (15') from my area
Cyr riparian �'tccess unless waived by me.
I doubt wish to waive the setback requirement.
1 tln wish to waive that setback requirement.
----------------------------------------------
----------------------
DE-SCR-11"FlOiX AND/M ])RAWLNG OF PROPOSED DEVELOPMENT:
(To he filled in by individual proposing developrncla)
44
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ALPk,
nle- P/1- 71I-,,► Sr 11 I:q 114 s✓rJ �i 1% r��7` �f7 e. �,��if a 7
---- _----..---•---------------------------------------------------------------------- IvE,
9
Signature - ,— J W 6-$.
—._—
Morehead City IDCM
Print ._or Type Name
l'elephone Number `—
Date:
JUN 28 2005 15;22 4 PRGE.02

JUN-28-2005 TUE 02:47 PM NC DIV OF COASTAL MGMNT FAX NO. 4 P. 03
Ct i '1�T 'I1�13 tiI.AIT, -- RE,-FTJR'.y REffC Xft REQUESTED
D1�'1ST.0'-"N' nl C0A.5T:1L Nl 1.\ G1,',N,I.ENT
tkDjA(:'I"\7 RIPARIAN I'ROPII-,PTI' OW�tNER `OTIl ICATION-1bV 1IVFR
PORNI
NIMIP Of illdividt'M al'Pl_i>itb for i C-
Arhlres; of propeuly.MO o D
(loc at su/_ce u, sctja cc mad) /
(City & county)
l hewby coltify that I own property adjacent to the above referenced property. `T'ho
individual applying For this permit has described to me (as shown on the attached
dalwinr) the development they are proposing. A description or drawing, with
(Iimc ilsiOns, should be provided with this letter.
I have no objections to this proposal.
If you hurc objcrtions to what is being proposer, please write the Division of Coastal
tilnrirr�>crrcerr ; 400 Commerce Ave., Morehead City, NC 28557 or call [phone]
wirlhin 10 riny,s of I-rceipt of flits notice. No response is Considered the sap:errs ne
obicclion if you have beer notifted by Certified Mail.
WAIVER SECTION
I un larstand that a pier, clock, mooring pilings, breakwater, boathouse, lift or sandbags
must lie set back a minimum distalua of 15' from my area of riparian access unless
Nvaivcd by rate. (if you wish to waive the setback, you must initial the appropriate bias k
below.)
\yam/
I do wish to waive tho 15' setback requirement. JUL Q I Z005
I (10 110t wish to waive the 15' setback requirement.
Morehead City ®CM
.)'-kpliam Mimbcr NI ilh Area Cb,k,
JUN 28 2005 15:22 4 PAGE.03

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.TUN 29 2005 13:16 2527292603 PAGE.02

JUN-28-2005 TUE 02:47 PM NC 6IV OF COASTAL MGMNT FAX NO. 4 02
AWACEINT RrPlUtIAN PROPERTY OWNER STATENtENT
(rOR A P1FR HO.ORMG PfffiVGSIBOATLIr.,TiBo I TIIOU,S1,)
I
I
I hcrtt�,� r�:rtify 0h,1t I own property adjacent to g� �� ��"�' L� s
1 (Naule of Property Owner)
p roph-rty loci tc-d a, b �% --y s 1�� x.
(l..ot, Block, Road, etc.)
--AIs l�� N.C.
(t';�nicrUudy) ('Cown andlor County)
He has dcscribcd to irie, as shown below, the development he is proposing at that location,
Inc{, I Jim. no objections, to his proposal. I understand that a pier/mooring
plll[lgslUQi'!t{lftlbQ�lilL1US� nluSL beset back a minimum distance of fifteen feet (15') from my are"
of rihari I acc,,ss unless waived by me.
1 ii!? 01 wish to WMW the StIback requirement. ,
1 0111 'XiSh to .:civc that solblick requirement.
------------------------------------------------ ----
DE-S(:Lt.l1'7'IOiN AND/Ok DRY WLNG OF PROPOSED 1 MW*w"'
(To he filled in by ir+ulivirlual proposing developrncia)
re
a{P/a77.V-� s�Gl�,
y1�rt�D"s Puxt z4..r l
Me 4T 9/0-zaa-0JO'Z
Snature
Print or Type Name
elelshone Numher �•• ��—
Date: � 4 0f._
JUN 28 2005 15 ; 22 4 PAGE. 02

`JUN728-2005 TUE 02:47 PM NC DIV OF COASTAL. MGMNT FAX NO. 4 P. 03
CER'llf'JEU ti AIL -- I2Y,',TTJRN RECEIPT RF,QUESTED
DItiIST.0N 01' COA,S'rAL
AW.m"Y NT 1%"l1'I<I_+ N 11RC)P11.RTY OWNER NO'rff ICATIOti/l-FAIVf;R
r'ORNI
Of ill Mviclu:tl-IOp1_1ilry for hermit: --�onF.%�( 7a f �L.�/rI --Z'7vrJw,, Z L
Arldres� of property: 0,0b
(tot oa/
r ur_ct x, srrsar orro")1 /
(city & Cauntyy) _
I lter0by casctiCy that I own property adjacent to the above referenced property. The
individual applying for r�:is permit has describcd to nic (as. shown on the attached
dtltwialg) the development they Are proposing. A description or drawing, with
(intct'sions, sl , uld be provided with this lcttar.
I have no objections to this proposal.
Jfyof-i have objeriionsto what is beirtg proposed please write the Division of Coastnl
tl9rrrr:agemene) z100 ("orrnrterce Ave., Aforeltead City, NC 28557 or call (2S2) 80&2808
r�irhin 10 rk<tys Of receipt of this notice. No response is corxsidered tke same as no
a7 icctinn if yoga have been notif ed by Certified Mail.
WAIVER SEMON
I uliclarstind that 1 pier, clock, mooring pilings, breakwater, boathouse, lift or sandbags
mu.et lie sit back a minimum distance of 15' from my area of riparian access unless
xvaivrd by me. (if you wish to waive the setback, you must initial the appropriatz blank
below.)
I do wish to waive the 15' setback requirerent.
isk 1 clo rot W4 y _ Wish to waive (ham 15 setback requirement.
Sit;ua.rtc'' U:r
30.J=�H pa _>S� r rck')
t`r iu( N:naie
Toff-Pl,ar,c Nkwib<c Area Co,',;., _.
JUL 0 8 2p05
Morehead City CCM
JUN 28 2005 15 : 22
4 PAGE.03

GAmA�I�N�
�/01l tirmnu�LZ, �Ql�;Alt le ol
i t it 1 i i I i} i i1Fl3. i i j33 �i 1i I'

JUN-28-2005 TUE 02:47 PM NC DIV OF COASTAL MGMNT FAX NO. 4 P. 03
•rt1�l1"D MAIL -- RETURN RECFXPT �
DIVISTWN Ql COAS'EkL r.�.`,iC,r.�>>✓1`�r JUL 1 2 Z005
ADJA(*'1- \T I:IPARI.+ ` PROPEIRTY OtiV,"�iER, NOTIF ATION/1VAIVI'';R
FORM orehead City DCM
Nil31w of in iiiviclum at, piving, roi• perniit•.�
Arhlres� of property: OW Road
~(lot off st1:ct #, stt[cit orroad)
/ 1
116jea.
(City & county)
I hereby ckuliCy that I own property adjacent to the above referenced property. Tho
individual applying for this permit has dt:scribed to me (as. shown on the attachod
daiwinn) the development they are proposing. A description or drawing, with
din1W3ions, shQL1ld be provided with this lctter.
-` I have no objections to this proposal.
_-- 3 P P
If you harc objections to what is being proposer, please write the Mision of Coastal
Alanagen-terie, 400 Commerce Ave., Morehead City, NC 28557 or call [phone]
wirl:irr 10 cl"ys of receipt of INS notice, No response is considered the sane as no
ohjccdon iJ'you have been notifed by Certified Mail.
WAIVER SECTION
1 tutele.
rstnnd that 1 pier, clock, mooriue pilings, breakwater, boathouse, lift or sandbags
must lit; set back a minimum distaticc of 15, from my area of riparian access unless
%vaivcd by rnt:. (If you wish to waivo the setback, you must initial the appropriate blank
below.)
__._. I rlo ish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
4=�4 '41�) P0 /I /' -
S it:uasurc Uale
_ 3YZ3 t�
1'rtr•i,1,on��N�n�th,�c N•ilh Arc;t C'a�„: y ..._ ., _.
JUN 28 2005 15:22 4 PAGE.03

JUN-28-2005 TUE 02:47 PM NC DIV OF COASTAL MGMNT FAX N0. 4
CIF
\\ cV
JUL I .? ?no5
A AJA,(„L ('r1Vr R fPMtif+ N' PROP1ZTY OWNER STATEP T NT
(FUR A IV RIMOORING PIUNGSIBOATGIFT/,1 "l�°11'hf�J:'ky) ®It [D ' ,fk
1' hcrcbY Certify that I own property adjacent to gesl L
L�✓ve >~ ah,Nrr�
's
/ (Name of Property Owner)
i�rn, rty loc•ctc rl a t b 0 (
(Lot, Uock, Road, etc.) ,
Oil _ in —Arl�
_____.._•�t'yaicrbocily) ...� „ �N.C.(Crownand/or County) ,
Ile, has dascribcd to icie, as shown below, the development he is proposing at that location,
anti, I have no objections. to his proposal. I understand that a pier/mooring
pilinhs/ho;uliftlba�,thc�use must be set back a minimum distance of fifteen feet (lS') from my area
of riparian ,10-ess Unl,_ss waived by me.
-k,1101 wish to waive the 96back requirement.
_.... ........ _. Z dq ,cish to waive that setback requirement.
------------------------------------- --
DILSCILM TION ANTWOR DRAWING OF PROPOSED DEVrLOPMEM.,
(To he filled in by iridivirlual proposing developmem)
/f7�-�
r
,0/etc Ze,1,
10W —010'z
-------- ---------•------------------------------ ------ .,------------- •------------
-��;�
Signature
Print or Type Name
I
d
Telephone Number `—
Date:
JUN 28 2005 15; 22 4 PAGE. 02

j SARAH Y. WILLIS
PO BOX 143
MOREHID Cl y, NC 28557

JUN-28-2005 TUE 02:47 PM NC DIV OF COASTAL MGMNT FAX NO. 4 P. 03
• C, k�Il��1'i•C<'IED Al AI IJ -- I-,'r IJR: \ RJR \IE
DI � 7STO ()l' CO AS'r_�L � 1-t G'T,',N1ENT
�U)J:1('I''N7 P IPATtI_+ ti PROPEP.TY OWNER N O'TIl, ICATI0'N/V A1Vf,;RF �
PORNI
ti:u�tt' nt' in�iiviclu.�l alzl,lvir�g ror l,crr»it—la,,.i_o^7a..� ��.� �v�s7»'�j,( ZL
Arldres- of property: b D b
(iot as s4//:ct k, strut or/road)
��yur'J�e� �lsl�n� Ca�f�'P.� Covh7'
(City & county)
f 1iCrc$y colt I 1Y that I owia property adjacent to the above referenced property. The
individual applying for this Permit has described to me (tts shown on the attached
chewing) the development they Arc proposing. A description or drawing, with
dirnci:Sicils, should be provided with this lctler.
I have no objections to this proposal.
If you havc objections to what is being proposed please write the Diyision of Coastal
-iffunagenzerr; 400 Commerce ,4 ve., Morehead City, NC 28557 or call (2S2) 808-2808
✓liritirt In drys of receipt of tills notice. NO response is considered the same as no
Oicctian if yore ha ye been nolifced by Certif ed Mail.
WAIVER SECTION
I iiiidarstnod that a pier, (lock, mooring pilings, breakwater, boathouse, lift or sandbags
n)ust be sct back a minimum distance of 15' from my area of riparian access unless
waived by rac:. (If you wish to waive the setback, you must initial die appropriate blank
below.)
I r3a wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Si : [Qri t]:Ill
1'r1+'V140fie Nuttiber ti)'itb Arc.t C'o,:o
JUN 28 2005 15:22 4 PAGE.03

JUN-28-2005 TUE 02:47 PM NC 61V OF COASTAL MGMNT
FAX NO. 4
P. 02
(FOR A PIERMOORING PILINGSIB0, ILIFTIRO"jTIIOUSE)
I hcrcby cevify that I own
property �tdjaccnt to's � ;:
_ ,
(Naurae of Property Orvrter)f
pro1?.:rty lotstcrl at
(Lot, Block, Road, etc.) ,
6�t _ in A—�
aicrbody)N.C,
(V /or County)
ITo has described to me, as shown below, the development he is proposing at that location,
u—Id, I hnvu no objections to his titr)YuSai. 1 u-idcl-stand chat a pic:iimooCing
hilinns/ho;ttlitt/bc�;,tlu�use must be set back a minintu►n distance of fifteen feet (15') from my area
of riparian accOss Unless waived by me.
..__ T02-trot wish to waivz the setback requirement.
1 t1n wish to waive that setback requirement.
---------------------Y ------------------'------------------------------------------------------------------------
DESCRIPTION AI` WOR DUAWLNG OF PROPOSFM DEVELOPMENT:
(To be filled in by individual proposing developrneict)
-- — — - , e �"� Tie
'000,0,0
Ole
�� ti � 9fa -r�d2 —DI02
Si tore
�c "� b - _ Sc-e f 4v,\
Print or Type Name
Telephone Number _
Date:
JUN 28 2005 15 ; 22
4 PAGE.02