Bow to Stern Inc, Co James Edwards

6PAM^ / 011DREDGE & FILL S.` No. 73384 A B C D
GENERAL PERMIT Previous permit#
nNeW ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
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 '
[Rules attached.
Applicant Name _ Project Location: County,i r
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Address " _ Street Address/ State Road/ Lot #(s)�l I tr�j
City _ State ___-. ZIP i '
Phone#(r` ) i E-Mail
Authorized Agent
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Agent or Applicant Printed Name
Signature ""Please read compliance statement on back of permit••
117/prT
Application Fee(s) Check #
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PermitOfflcer's Printed Name,
Signature
Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: -/Yolf) -fo 54'eYA) �ZbC. Z 7&A l E4,
Mailing Address: ho lynx 59(� /)r3A)(, zFS'7/
Phone Number:
Email Address:
I certify that I have authorized
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at Z
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in �w�.�cp County.
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I furthermore certify that 1 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:
['�e�SZ1i7Ci�
Signature
SUM M. EAA)A-JV d
Print or Type Name
Title
iZ /
Date
This certification is valid through

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street or Road,
Agent's Name#: (� �,,� jnlar� Mailing Address: Z.?Vy(,J/1.030�
Agent's phone #: 779- yuy &y6oinJ .UG VS-15—
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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 drawing, with dimensions, must be provided with this letter.
VI 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 Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at htta:/Aaww.nccoastalmanagement. net/web/cm/staff-listing 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
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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 Owner Information)
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Signature
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Print or Type Name
Mailing Address
City/State/Zip
zS Z.'{'7�.6000
Telephone Number/Email Address
10 �� P
(Riparian Property Owner Information)
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Print o Type Name
336 744,ell /3/ �i.✓
Mailing Address
Q,k,e4A/ / A)( ZC S"/j
City/StatelZip
17
e ephone Number/ Email Address
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Date'
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(Revised Aug. 2014)

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: 15ill) f& CFI r�ZY11ddt=S
Address of Property: Zqp '7?oC4A;, � 1 4ntid, 727 D)7te1%p
(Lot or Street #, Street or Road, City &
Agent's Name #: I)IMI te, II)fAIA)L Mailing Address: 73'1? �1ff�L&)�, 3pY
Agent's phone#: 219-iA0, P,.Auito A)f _ Zfflr
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 drawing with dimensions, must be provided 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 Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http://www. nccoastalmanagement.net/web/cm/staff-listing 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
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.
CAI do not wish to waive the 15' setback requirement.
(Property Owner Information)
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Signature
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Print or Type Name
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Mailing Address
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City/State/Zip
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Telephone Number/Email Address
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Date
(Riparian P Owner Information)
Signature
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Mailing Address
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City/State/Zip-
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Telephone Number/Email Address
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(Revised Aug. 2014)

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