Deal, Robert

I CAMA / ❑ DREDGE & FILL
'GENERAL PERMIT
New ❑Modification ❑Complete Reissue []Partial Reissue
I►CeaUm
Previous permit #_
Date previous permit
A B C D
As authorized by the State of North Carolina, Department of Environmental Quality r
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC �, �I'^/� 4-
N Rules attached.
Applicant Name
Address
I
City a �� State
r
Phone # ('��) 'r /`/ E-Mail
Authorized Agent
ZIP
Affected ❑CW ,E]EW ❑PTA LES ❑PTS
AEC(s): M OFA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWs:
ORW: yes / no PNA yes / no
Agent or Applicant Printed Name
Signature *'r Please read compliance statement on back of permit'"'
Application Fee(s) Check #
Project ocaton. ounty
Street Address/ State Road/ Lot #(s) n L�
City ZIP
Phone# O River Basin `1�.
Adj. Wtr. Body —/ :- nman unkn
Closest Mal. Wtr. Body
Permit Officer's Printed Name 1
Signatu e
7
Issuing Date ExpirationDate

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit. �Z_i) be,r i A tVenoQ DeQ I
Mailing Address:
Phone Number:
Email Address:
I certify that I have authorized
A Q) 'SyS-8(a\y
Mquin I wnuacw,
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: _Q cv �aPGI�' fit.
at my property located at"�—
in County.
I furthermore certify that / 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 ner Information:
eo<G/ �x
Signature /
Print or Type Name
Title
1�fZ 1'.9019
Date
This certification is valid through 4V /Z_/ D/

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property: Q(-o��eCK`
(� ,(,L�ot�lo�r�S,ttrreet ##,, Street or Road, City & County)
Agent's Name #: Wb IJt�,1 VGf I 1'F- Mailing Address:
Agent's phone#: 1I0'330" rJ5iO —.a
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,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
(DCMj In writing within 10 days of receipt of this notice. Contact information for DCM offices is
available athtip://www.nccoastalmanaaement net/web/cm/staH-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been noted 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.
Eober-4- Deal �►r .
Print or ype Name
1 ? U fi m stne, Dr.
Mailing Address
SY1Ca& RYYU NU,2SWO
City/State/Zip
q I D - 546-bpi L1
Telephone Number/Email Address
-2-19
Date
(Riparian Property Owner Information)
Signature
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number/Email Address
�/ 4-11 /%
Date
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONlWAIVER FORM
Name of Property Owner:
Address of Property: \ 9 v�
(Lot or Street #, Street or Road, City & County) I
Agent's Name #: , )I ins far ber ��2 Mailing Address: ) 3� nj� LY) .
Agent's phone #: -1 I d— 930- r✓s�o°I - ����`� c'sr ,� ,�1��
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.
V/ 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.nccoastaimana_qement.netlweblcmls ff-listing or by calling 1-888-4RCOAST.
No response is considered the some 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.
Rcba� Dfa-I Jr.
Print or Type Name
12i¢ hxi ne br.
Mailing Address
niea&
City/State)Zip
41t,_ fiLIC.- (Z t U
Telephone Number/Email Address
1-Z- I°I
Date
Information)
rL-
, -2). /3o 1pyl&lwoN
Print or Type Name
�eirriTon/z-
Madi, ddress
City/state/Zip
C//O-Z/0`1
Telephone Number/Email Address
P7/13// �
Date
(Revised Aug. 2014)

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