Stone, Charles (2)

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-.. CAMA / 'J DREDGE & FILL No. 73445 A B C D
GENERAL PERMIT Previous permit#�
ew. ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality 7� ' )� r , / 3,/ t
and the Coastal Resources Cqmmissio man area o environmental concern pursuant to 15A NCAC / I 6. VV
f ❑ Rules attached.
Applicant Name r ✓ fJ ai'� Project Location: County 6�`e
V., I le,
Phone # (114�10-0 [
Authorized Agent )— 1
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AEC(s): ❑OEA
❑ PWS
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Agent or Applicant Printed Namne
Signat fi J** Please read compliance statement on back of permit"
00
Application Fee(s) Check #
PermitOfficer' P _ gd,(yame—.
Signature
Issuing Date

DocuSign Envelope ID: 603D4EBC-I0OC-4A1A-966C-2D5BEFFEA235
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: C had es S k n e-
Mailing Address: H33 AQ,k1 e- MDUnI-Q.yi dun 2
Phone Number: 336 - W1 ' UD 6
Email Address: %54-2yr(:fXq a-) �e4Met;� , d kA-
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: %& I k Apee r� fA2Q Lrt�
at my
yy))property located at G�� `1 S��FY I/,'�cJ Qi/. C7ArkPls /g Hit �L
in Lu l �rC r County.
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.
Property Owger Information:
C\`{1krles Sfyn�
Print or Type Name
Title
0/ I .251 �O/rf
Date
This certification is valid through

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: O&I-les S fn f1e
Address of Property:
(Lot or Street #, Street or F&ad, City & County)
Agent's Name MI-oAnn Mompi,\ MailliiingAddress: /31 Middle..LA
Agent'sphone#: �S�-7a3'3/tiiv Xu�AA�yr"1 N� ��iSlb
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:/Avww.nccoastatmanagement.net/web/cnr/staff lisUnu 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.
26 1 do not wish to waive the 15' setback requirement.
(Property Owner I ormation)
SiKnahu•e
�huylP� S�-o11e
Pnnt or Type Name
933 4ra;e,
Mailing Address
ay/at5V;�IP
ity/ tat�y C
336• 9/6- 000-
Telephone Number/Email Address
o/ -.2s- -2o/9
Date
(Riparian Property Owner Information)
Signature rq
danolo l,a4 G-ad u
Print or Type Name
0.� ox /(05 y34 61fy✓:ewn..\
1�4tr)ors7aro t )%
Mailing Address
OcArkers ISIAnd. A/C aks31
City/State/Zip
Telephone Number/Email Address
(-
Date
(Revised Aug. 2014)

DowSign Envelope ID: 603D4EBC-i DOC-4AtA-966C-2D5BEFFEA235
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Charles 20 nt
Address of Property: q, 7 q% 4A4 ✓t ('It) br. )41 rkers -2- 14 ndt AL 2 kS
(Lot or Sireet #, Street orRoad, City & County)
Agent's Name SO AM)I CLnQ kA W\, Mailing Address: far' AMC Lone
Agent's phone#: (;i -7 - 319(, .U�Ak- 02esIh
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
thesing. A description or drawing with dimensions, must be provided with this letter.
I"A3ve 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 httn://www.nccoastalmanaoementnoViveb/cm/staff listing or by calling 1-8884RCOAST.
No resnonse is considered the same as no obiection ff you have been notified by Certified Mail.
WAIVER SECTION
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.
(Prope I Owner 1 ation)
(Riparian Property Owner Information)
Et
/, 1DocaignW by -
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Signature
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Print Type N
Pint or Type Name
or
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yg X4ckl,H4 ( hair_ �41te-
Mailing Address
Mailing Address))
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N
Fraklkliv. /VL �2ff- '
Ci�tate/Zip I
City/statelzip
9I6 , 60 -
so(e • 3r d z
Telephone Number/Email Address
Telephone Number/Email Address
Ol-,zs- -a019
Date
Date
1/29/2019
(Revised Aug. 2014)

ouSign?vlelo e,D. 603D4EBC-I DOC-4AIA-966C-2D5BEFFEA235
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VERNON WAYN'E JONNSON
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Thie ma.. •e ..-.� s.,_ ____-. ... ATE ... RMeiph. N.G 27603 SURVEYING