698-13_Cannon, Gail_20130520

05/'0/2013 MON 12! 01 FAX -+-4 LAMA
2001/002
Carteret Court
Local Government
698-13
Permlt Nun
LAMA
MINOR DEVELOPMENT
PERMIT
as authorized by the State of North Carolina, Department of Environmen4
and Natural tteaoumea and the Coastal Resources Commission for development
In an area of environment concern pursuant to Section 113A-116 of the
General Statutes, "Coastal Area Management:"
Issued to Gail Cannon, authorizing development in the Estuarine Shoreline - ORW (AEC) at 109 Brown Street, in
Marshallberg, as requested In the permittee's application, dated May 3, 2013. This permit, issued on May 20, 2013, is
subject to compliance with the application and site drawing (where consistent with the permit), all applicable regulations
and special conditions and notes set forth below. Any violation of these terms may subject permittee to a fine,
imprisonment or civil action, or may cause the permit to be null and void.
This permit authorizes,, The construction of a new front stairway and a new side meter access platform.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on May 3, 2013.
(2) All construction must conform to the N,C, Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood Regulations.
(3) Any change or changes in the plans for development, construction, or land use activities will require a re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site, Contact this office at 252-728.WS for a final inspection at
completion of work,
(5) Pursuant to 15A NCAC, Subchapter 7J.0406 (b), this permit may not be assigned, transferred, sold or otherwise disposed
of to a third -party.
(Additional Permit Conditions on Page 2)
This permit action may be appealed by the permlttee or other qualthed persons
within twenty (20) days of the Issuing date. From the dale of an appeal, any
work conducted under this permit must cease until the appeal is resolved. This
permit must be on the project site and accessible to the permit officer when the
project 16 Inspected for compliance. Any maintenance work or protect
modification not covered under this permit, require further written permit
approval. All work must oease when this permit expires on.
DECEMBER 31, 2016
In issuing this permit it Is agreed that this project Is consistent with the local Land
Use Plan and all applicable ordinances. This permit may not be transferred to
another party without the written approval of the Division of Coastal
Management.
t
J.D. O'Neal
CAMA LOCAL PERMIT OFFICIAL
402 Broad Street
Beaufort, NC 28516
a
TTEE
(Signature required If conditions above apply to permit)

05/1 0/2013 MON 12- 02 FAX CAMA U0021002
'_ j
Name: Cannon, Gail
Minor Permit # 698.13
Date: May 20, 2013
Page 2
(6) The amount of impervious surface shall not exceed 25% of the lot area withln 575 feet of Normal High Water
(Estuarine Shoreline - ORW Area of Environmental Concern), in this case, 26,789 square feet is authorized.
(7) Unless specifically allowed in 15A NCAC 07H. 0209(d) (10), and shown on the permitted plan drawing, all
development/canstruction shall be located a distance of 30 feet landward of Normal High Water. No portion of the
roof overhang shall encroach into the 30 ft. buffer.
(8) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Prior to any land -disturbing activities, a barrier line of filter cloth must
be installed between the land disturbing activity and the adjacent marsh or water areas, until such time as the area
has been properly stabilized with a vegetative cover.
(9) Any proposed for grading within the 30'buffer from the Normal High Water must be contoured to prevent addltlonal
stormwater runoff to the adjacent marsh. This area shall be Immediately vegetatively stabilized, and must remain in
a vegetated state.
(10) All other disturbed areas shall be vegetatively stabilized (planted and mulched) within 14 days of construction
completion.
(11) Prior to any development, silt fence shall be properly installed between all planned land disturbance and the
adjacent marsh and open water areas; the slit fence shall be properly maintained throughout the construction
period. Slit fence shall be installed such that it is properly toed -in to the soil.
(12) This permit does not authorize development within any wetlands or open water areas,
SIGNATURE, ' 7 DATE: -
PERMITTEE

Localityccke6&A Ccu4h4Permit
Number
Ocean Hazard Estuarine Shoreline
ORW Shoreline
(For official use only)
Public Trust Shoreline Other
U
GENERAL INFORMATION
LAND OWNER
l U
Name Gail Cannon
i A
Address 108 Brown Street —/1KA
/09 E340e0wv A; ietiR_T
City Marsha:iburg State
NC Zip 28553
Phone [phone]
Email [e-mail]
AUTHORIZED AGENT
Name Seagander Enterprises, Inc. dba Kulin Construction
Address 112 Nine J Drive
City Newport State
NC Zip 28570
Phone [phone]
Email [e-mail]
LOCATION OF PROJECT. (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.)108 Brown Street, Marshallburg, NC 28553 - Core Sound 14K14 / 04 J517D t v.✓ t ?,
Fkto.417
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) /(/ab✓ $ /iJ/IL G✓/f
/? t/P&
SIZE OF LOTIPARCEL: square feet 2•46 acres Mr.=s'
jo6r¢TPot�s
PROPOSED USE: Residential ✓0 (Single-family 0 Multi -family Commercial/Industrial ❑ Other ❑
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer iifyou are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: %3� square feet (includes the area of the roof/drip line of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State Storrnwater
Management Permit issued by the NC Division of Water Quality?
YES= NCCEE�j
Ifyes, list the total built upon arealimpervious surface allowed for your lot or parcel: square feet
OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
1, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in anAEC or a
person authorized to act as an agent for purposes of applying fora CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one)
Zan owner or record title, Title is vested in see Deed Book
page in the County Registry of Deeds.
Oan owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County.
Qf other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OFADJACENT PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
(1) Ds,a/t'4 41fy/S /a7 $72z1:1r7-
(2) YN,—,* etX 3/ / UBuc,c 1:Pe,,yXi /?Di¢,C>
(3)
(4)
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I furthermore certify that I 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.
This the 3 tF" day ofM,4 X, 20 .3
Landowner or person authorized to act as his/her agenfrpurpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean HazardAEC Notice where necessary, a check jor $100.00 made payable to the locality, and
any information as may be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation of
any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action.

SITE DRAWING/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA minor development permit.
The Local Permit Officer will help you, if requested.
PHYSICAL DIMENSIONS
Label roads
= Label highways right-of-ways
_$0 Label local setback lines
Label any and all structures and driveways currently existing on property
Label adjacent waterbody
PHYSICAL CHARACTERISTICS
_Drew and label normal high water line (contact LPO for assistance)
Draw location of oa-site wastewater system
If you will be working in the ocean hazard area:
-4&L Draw and label dune ridges (include spot elevations)
-4eg-Draw and label toe ofdunes
Identify and locate first line of stable vegetation (contact LPO for assistance)
Draw and label erosion setback line (contact GPO for assistance)
Draw and label topographical features (optional)
Ifyou will be working in a coastal shoreline area:
—L� Show the roofoverhang as a dotted line around the structure
Draw and label landward limit of AEC
L.Draw and Label all wetland lines (contact LPO for assistance)
_e- Draw and label the 30-foot buffer line
DEVELOPMENT PLANS
Draw and label all proposed structures
At ,4 Draw and label areas that will be disturbed and/or landscaped
1l/L4 Note size of piling and depth to be placed in ground
-40- Draw and label all areas to be paved or graveled
M44 Show all areas to be disturbed
.4:;f- Show landscaping
NOTE TO APPLICANT
Have you:
• completed all blanks and/or indicated if not applicable?
• notified and listed adjacent property owners?
• included your site drawing?
• signed and dated the application?
• caclosedthe S100.00 fee?
• completed an AEC Hazard Notice, if necessary? (Must be signed by the property owner)
APPLICATION FOR
CAMA MINOR
DEVELOPMENT
PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area Management Act
(CAMA) and set the stage for guiding development in fragile and productive are" that
border the state's sounds and oceanfront. Along with requiring special care by those who
build and develop, the General Assembly directed the Coastal Resources Commission
(CRC) to implement clear regulations that minimize the burden on the applfeaut.
This application for a minor development permit under CAMA is part of the
Commission's effort to meet the spirit and intent of the General Assembly. It has been
designed to be straightforward and require no more time or effort than necessary from
the applicant Please go over this folder with the Local Permit Officer (LPO) for the
locality in which you plan to build to be certain that you understand what information he
or she needs before you apply
Under CAMA regulations, the minor permit is to be issued within 25 days once a
complete application is in hand. Often less time is needed if the project is simple. The
process generally takes about 13 days. You can speed the approval process by making
certain that your application is complete and signed, that your drawing meets the
specifications given inside and that your application fee is attached.
Other permits are sometimes required for development in the coastal area. While these
arc not CAMA-related; we urge you to check with the Local Permit Officer to determine
which of these you may need. A fiat is included on page two of this folder.
We appreciate your cooperation with the North Carolina Coastal Management Program
and your willingness to build in a way that protects the resources of our beautiful and
productive coast.
DCM Form ES 1952.20lWRcuiscdApril 2010
Coastal Resources Commission
Division of Coastal Management
..... . o . .. 6.J
y
a
El M
OU0

RECEMD
JUL 2 4 2013
DCM T,IHD CITY
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 9/�iif/t� A 0/3
Name of Property Owner Applying for Permit:
Cs2 a i / <� 2 /!.-» 1-1�
Mailing Address:
f�lL�2��G✓�/�2�^�pI^�5�1'�rHC
I certify that I have authorized (agent) d6o Re /; ,, C'e,.)L;d,, to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) lyLoy- hi s r T b / �� 2 /Jjt� c 7-
at (my property located at) / D S /49 a wey S T'/L/Z Gr 7—
This certification is valid thru (date) Cred p,,o
Property Owner Signature I Date

JUL 2 4 2013
DCM--mm CITY
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner g" ; /
Address of Property: /4Jr l'/d 9 > ,� i•� kw-
(Lot or Street #, Street or Road, City & County)
SAA4,00No.Fie a s0 -#ti C. db•a
Agent's Name #: A& /:" Mailing Address:l1,2 7- ©2_
Agent's phone #: _�?�5v?. ,,?.Z $_ y,g6eo "r✓jp ore T- .�/G st t�?�
X I hereby certify that 1 own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing' with`dimenslons must be nravided with t6i.
I have no objections to this proposal. I have objections to this proposal.
If you have objectlons to what is being proposed, you must notify the Division of Coastal Management
(DCM) In writing within 10 days of receipt of this notice. Contact Information for DCM offices is
available at www.nccoastalmanaaement net/contact dcm htm or by calling 1-888.4RCOAST. No
response is considered the same as no objection if you have been notified by Certfed Mall
WAIVER SECTION
X I understand that a pier, dock, mooring pilings, 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 mus_nitial the appropriate blank below.)
- - I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prop e Owner Information)
Signature
-- 49�fti/ e 41VitCLj2 ..
Print or Type Name
/ 09, � /�'d Mire eSi'�i►t! �-
Mailing Address
CityMatw2ip
49" , a,2 9. 3oRr'
Telephone Number
Date
X
(Adjacent Property Owner Information)
Signature
TQ».eta Do a&r" a uar
Print or Type Name VF
,?// g Aurd /Feud
Mailing Address
Cdy/Stat&0p
X
Telephone Number
x
Date
Revised eVI&2012

RECEIVED
JUL 2 4 2013
DCM MUD CITY
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: (2 4* 7 a rs
Address of Property:
/do
(Lot or Street #, Street or Road, City & County)
$Ei¢6exivoo R a NT�R�itrs�ac 1� / A✓e. GfbwW K.c / = ro 0 • y si�i+s a *1 opt
Agent's Name #: 19. 4, k t /; h Mailing Address: /i 2— ti i r• 4 T D/2,
Agent's phone #: ,���� _ R 3. Ll.S �1� /y/3I✓pok /Y 1Z cr 7 O
/C I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. Adesorintion or drawing with`dime63ions"must be nroy ,ed with this Letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coasta/Management
(DCM) in writing within 10 days of receipt of this notice. Contact Information for DCM offices Is
available at www.nccoastalmanaaementnet/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail
WAIVER SECTION
X I understand that a pier, dock, mooring pilings, 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.
(Prope (-Owner
rIInformation)
Signature
C.ss Q i/ C-el hIV On
Print or Type Name
Mailing Address
, X 3
City/Statw0p zap z&
_as'a. .7a 9, 3 A CS;- i
Telephone Number
Date
(Adjacent Property Owner Information)
n
Signature
'oe-bea
Print or Type Name
187
Mailing Address
A&-on_-c4 •��b�c ray /LG �S,SS'3
City/State/Zip
ow
Telephone Number
X
Date
Revised 6/18/2012

•U.S' Postal ServiceTA,>
CERTIFIED MAIL. RECEIPT
(Domestic Mail Only, No insurance Coverage
Provided)
For delivery Information visit our website at www.uspsxom,
�I
:
i
PS Form 3800, August 2006 See
Reverse for Instructions
U.S. Postal Servicert;,
rl=PTIFIFn MAIL,, RECEIPT
(Domestic Mail Only,
No insurance coverage rrovioe❑)
for delivery information
visit our website at www.usps.com
SIR
PS Form 3300 August 2006=
` See Reverse for Instructions'
NEWPORT MAIN PO
NEWPORT, North Carolina
285707929
3613950570 -0098
05/03/2013 [phone] 02:41:27 PM
Sales Receipt
Product Sale Unit Final
Description Oty Price Price
MARSHALLBERG NC 28553 $1.32
Zone-1 First -Class
Large Env
2.60 oz.
Expected Delivery: Sat 05/04/13
Return Rcpt (Green Card) $2.55
99 Certified $3.10
Label #: 70112970000217940464
Issue PVI: $6.97
MARSHALLBERG NC 28553 $1.32
Zone-1 First -Class
Large Env
2.60 oz.
°a
Expected Delivery: Sat 05/04/13
C
Return Rcpt (Green Card) $2.55
IN Certified $3.10
9
Label #: 70112970000217940471----
r-
n,
Issue PVI: $6 97
c?
►.�
o
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Total: $13.94

CARTERET COUNTY,
NORTH CAROLINA
AFFIDAVIT Or PUBLICATION
Before the undersigned, a notary public of said County and State, duly commis-
sioned, qualified, and authorized by law to administer oaths, personally appeared
Misty L. Poff who being
a
first duly sworn, deposes and says that he (she) is Clerk
(Owner, parulcr, publisher or other officer or employee
authorized to make this affidavit)
of THE CARTERET PUBLISHING CO., INC., engaged in the publication of a
newspaper known as CARTERET COUNTY NEWS -TIMES, published, issued,
and entered as second class mail in the Town of Morehead City, in said County
and State, that he (she) is authorized to make this affidavit and sworn statement;
that the notice or other legal advertisement, a true copy of which is attached here-
to, was published in CARTERET COUNTY NEWS -TIMES on the following
dates: 05/08/2013
and that the said newspaper in which such notice, paper, document, or legal adver-
tisement was published was, at the time of each and every such publication, a news-
paper meeting all of the requirements and qualifications of Section 1-597 of the
General Statutes of North Carolina and was a qualified newspaper within the mean-
in- of Section 1-597 of the General Statutes of North Carolina.
This 8th day of May, 2013
Sworn and subscribed to before me, this:
8th day of May, 2013
, tvoyp\S B 14j,
j, "k,
oo
a C �gA
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Nota
Rv ry Public
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iFt �111n1ission gFF'afi s November 11, 2017
oy� �'9�1' Cav oo,.
'F::r. RECr.WED
• t'
'r
JUL 2 4 2013
�T
DCM--MUD CITY
NOTICE OF FILING OF
APPLICATION FOR CAMA
MINOR DEVELOPMENT
PERMIT
Pursuant to NCGS 113A-119(b), Carteret County Planning
& Development, a locality authorized to issue CAMA
permits in Areas of Environmental Concern, hereby gives
NOTICE that on May 3, 2013, Gail Cannon applied for a
CAMA Permit to construct a new front stairway and a new
side meter access platform at 109 Brown Street,
Marshallberg.
The application may be inspected at the address belov.•
Public comments received by May 23, 2013 will be
considered. Later comments will be accepted and
considered up to the time of permit decision. Project
modifications may occur based on further review and
comments. Notice of the permit decision in this matter will
be provided upon written request.
J.D. O'Neal
CAMA Local Permit Officer for
Carteret County Planning
& Development
402 Broad Street
Beaufort, NC 28516
[phone] My8
July 0 5 2013
a0100093
13568167

1/
C.C.
RECEIVED
'
JUL 2 4 2013
DCM-MHD CITY
i
i
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ly
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CAMA PROJECT TRACKING SHEET- CARTERET COUNTY
Applicant's Name: � n nA Date submitted:
Property Address: �►(,�y n ��. PIN #: .140
Phone #*1 .3 (�
Area of parcel in AEC: square feet acres obi �`� n
11
Proposed Impervious area: square feet Total impervious area allowed: square feet
�575' ORW 1751 AEC EXEMPTION Ciiio%—
Riparian Rights Statements / Certified Letters in filel!5)NO
Date of Site Visits:
Opplication considered accurate and complete for processing Date: 5!o 1 11-:5 LPO(initial)j b ,)
I Application returned for the following reasons:
Date Returned:
The following site -specific observations have been made:
The following conditions are to be included on the permit (in addition to standard conditions):
(Circle condition number) Q4TV U5 7 8 9 10 11 12 13 14
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
30 31 32 33 34 35 36 V 38 39 40 41 42 43 44
4 46 47 48 49 50 51 52 53 54 55 56 57 . 58 59
Other Note
a
Follow-up date visits:
Date: ,� — 6 — 2 ©( 3
I Project determined to be in compliance with permit Final Inspection Date:
I Project determined to be out of compliance with permit
Action taken to bring project in compliance with CAMA:
LPO: Date:

Jim Jennings, AICP
Director
Carteret County
Department of
Planning and Development
Main Office: Western Office:
Courthouse Square
Beaufort, NC 28516-1896
Tel: [phone]or 728-8545
Fax: [phone]
701 Cedar Point Blvd.
Cedar Point, NC 28584-8013
Tel: [phone]
Fax: [phone]
NOTICE OF FILING
OF APPLICATION FOR
CAMA MINOR DEVELOPMENT PERMIT
Pursuant to NCGS 113A-119(b), Carteret County Planning & Development, a locality
authorized to issue CAMA permits in Areas of Environmental Concern, hereby gives NOTICE
that on May 3, 2013, Gail Cannon applied for a CAMA permit to construct a new front stairway
and a new side meter access platform at 109 Brown Street, Marshallberg.
The application may be inspected at the address below. Public comments received by
May 23, 2013 will be considered. Later comments will be accepted and considered up to the
time of permit decision. Project modifications may occur based on further review and
comments. Notice of the permit decision in this matter will be provided upon written request.
J.D. O'Neal
CAMA Local Permit Officer for
Carteret County Planning & Development
402 Broad Street
Beaufort, NC 28516
252-728-8545
PLEASE PUBLISH ON: May 8, 2013

May.09.2013 16:20 Seagander Enterprises, In 252 223 4095
Seagander Enterprises, Inc.
Kulin Construction
112 Nine J Drive
Newport, NC 28570
phone: [phone]
fox: 252-223-4095
email: seaganderCearthlink.net
PAGE. 1/ 2
1 of �2, pages
Date:
fax: 7P-9-44`� email:
re: le g ?0,4� 97LI���- /NL
Air
r

May.09.2013 16:20
Seagander Enterprises, In 252 223 4095 PAGE. 2/ 2
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
^"Av /JOi*• 414009 Q,
Address of Property: /90 It 4/,0 r Z94a J,, e. ,r, 4,4%rmr+r,a 7- 4,0&,,w rY
(Lot or Street #, Street or Road, City & County)
SAI40iBA100-4e 11.vrArA&0Cisa.f� ♦A+ee, dba !IC"e/�r► C��.s>s.�..a-y`J�n
Agent's Name#: /:" MaiiingAddress: //,2- Alej.vlz .T pir.
Agent's phone #: QX47', 9 A & J1iw J62 Peg. ; 0& g-- _ A ram»
X I hereby certify that i own property adjacent to the above referenced property. The Individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing, A description or drawina..,with dimension&-must,be provided -with this IM.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you mustnotlfy the Division of Coastal Management
(DCM) In writing within 90 days of receipt of this notice. Contact Information for DCM offices Is
avallable at w,wnnccoostalmonaaemenLnet(contact dcm.htm or by calling 1.888-4RCOAST. No
response_ Is considered the same as no gVecdon N you have been notified by CertWed Mail,
WAIVER SECTION
X I understand that a pier, dock, mooring pilings, 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 1 S' setback requirement.
(Property Owner Information)
Zoe",
Signature
4Adk i /
Print or Type Name
Mailing Address
Clty/8tateop
Telephone—
(Adjacent Property Owner Information)
i%. �" D,-
Print or Type.Name
Meiling Address
�ate/Zip
Telephone Number
/ AfX Y .2. g2/ x vary .�
J J a l
Dale
Revised 611ao2012

May.09.2013 16:16 Seagander Enterprises, In 252 223 4095 PAGE. 1/ 2
Seagander Enterprises, inc.
Kulin Construction
112 Nine J Drive
Newport, NC 28570
phone: [phone]
fax: [phone]
email: seaganderCearthlink.net
1 of �2' pages
Date: 57,�,/3
TO: tpA-4�1
fax: 7P-9-44113 email:
re: log 41& � 9-1 RaA�la"& /

May.09.2013 16:16 Seagander Enterprises, In 252 223 4095 PAGE. 2/
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Properly Owner: g" ?/ �•a �.� .�
low �t�►�+-�r�•e4,
Address of Property: l'�pt �., ��r..,► .S' _ G±, %rA0fra 2- g �Y
(Lot or Street #, Street or Road, City & County)
-SA444Yo rn 's o-T-0erApie�esa X iN C. W464 kA$/)r,ae
Agent's Name #: Q,�_ '. r; rs Mailing Address: .
Agent's phone #: tea z .? A$. ys yo ,rY�N/im aor ,mac. ,fit t�a4p
X I hereby certify that I own property adjacent to the above referenced property. The Individual
applying for this permit has described to me as shown on the attached drawing -the development
they are proposing. E-deserintlon'or. drawing - WO ditee6110m must,beoravft3Uj(h tbis fetter.
I have no objections to this proposal. ,.„ I have objections to this proposal.
M you have objections to what /s being proposed, you must notl& the Divislon of coastal Management
MCN) In writing within 10 days of receipt of this nodce. Contact Information for DCM offices is
available at www.neco-ais(,O& gggment.net/eontsct dcm.htm or by telling 1.888.4RCOASr. No
responae Is considered the same as no ob/ection if you„u have been notified by Certified Mall.
WAIVER SECTION
ey I understand that a pier, dock, mooring pilings, 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 IS' setback requirement.
(Proi!.rly Owner Information)
f �;«� ,
Signature
Print or Type Name
Mailing Address
Clty/Stata0p
Telephone Number
(Adjacent Property Owner Infarmatlon)
ignaWe %r <� P!t fi
Print or Type•Name
6wd--- Jc
siLL._
Mailing ddmss
C
ltyMatelzip
x <Y6 6(-- -514. L-'O7y
Telephone Number
/ odf4 Y o �.� X M 4?% T, - /.3
Dare bate
Revised $/=012
E
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