Hart, Steven

,VCAMA /X DREDGE & FILL No 71676 A B C D
GENERAL PERMIT Previous permit#
UNew []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 I SA NCAC
ORules attached.
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.Agent or Applicant Printed Name
Signature a rea d [compliance statement on back of permit **
Application Feels) Check #
PermitOfficer's Printed Name

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 5-(tV Lf,)
Mailing Address: 644yt ' tj f�1�
0\1 �_ w (e g to ,_N C� S 0
Phone Number: ?/ 9 7-0 ( - - I Z 7
� 6 !
Email Address: CA� Cr�;t
�, cz) M+c • CUI ✓1
I certify that I have authorized C 2I L PA V E
Agent i Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
(ZE)tIOV4L UI_ 0 C PIL, ING
at my property located at -5 V D L= w %N O S 2D
in C 2q V E IV County.
l 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 Owner Information:
Signature
S-rl- v c/'i . 11 /L T
Print or TypeName
Title
4 / � / !/Y
Date
This certification is valid through ! !.

subject: RE: Dredging
From: [e-mail]
To: [e-mail]
Date: Wednesday, August 29, 2018, 4:42:08 PM EDT
Looks good.
I have attached 2 signed copies
Sent from my Samsung device
— Original message From: Cherylle & Skip Hird <[e-mail]>
Date: 8/26/18 8:38 PM (GMT-07:00)
To: Doug & Sandy Lockney <[e-mail]>
Subject: Dredging
Steve asks you to approve this proposal which includes dredging of the side of his dock next to Mary Jean. Time is really
getting tight as the dredger expects to be in NWCreek by the end of the week. We have all the paper work assembled
other than your signatures on the two riparian property owner statements. Steve appreciates your help in this and
apologizes for the shortness in timing.
Skip
A j Lu C (2 E FK
fZE MovE.=%�sr�r�� f't�rr
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LOCUS - ,,)Of -to
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r1,4r'tyS A.41 s7Evr' N/127 I ;DOUC Vocl"nC-i

A-17
ADJACENT RIPARIAN PROPERTY OWNER STATENfENT
I hereby certify that I own property adjacent to
111aKi'ic Cl Proimrl y Owner)
property located at XQ
on /J' yt) pi> (Address, Lot, Block, Road, etc.)
in iV?b -✓) i -Ayoar' I N.C.
(Waterbody) (Cityfrow and/or County)
The applicant has described to me, as shown below, the development proposed at the above
inr'iat;ctl_
I have no objeciior to this proposal.
t have objections to this proposal.
--OJ Yes
%v C C
ftr+PM,
3r- D2EOGEp
As A26A % 6 E
peck �' d t2E D(rEC
I understand that a pier, dock, mooring pilings, boat ramp, 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.)
_ tier v.; ,is `ter wage -me 'i 5' setoack requirement.
- ,�E a^.. err .+n ,_�-
- -._.. l... ?[4`C!,F4,.k3E'yr'':i` `:iF %8F%3i.4'C !:E r:,.* 54t :Lil :IL y".''e: C'eN'la'.r. ir...
(Property Owner Information) AAdrt A't"=`r, ° r
Signature Signature" Y
Print or Type Name PrintorType Nta-
SQr 1l %� DE WiAj C fA� --116 12c&'
Mailing Address • Mailing Address
r`Y{v�!StatPPi7in r
r 4�9 ixy/o(f]IESGI(7z-(i-7 clew--tai'd M4c z_�5'2--
Tefepho e M ber/e ail address �� M Telephone Number email address--'5 mC i ie:
Date . > r: Zc� /9' Cc a
Date
(RIeviseci Aug. 20-N)
`Valid for one calendar year after signature*

Dcue_ L.
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 5')1, PH EN Al.
.+., I f/J /t.( f o I/1 n r ! ,.�
pivpcl ty Il�ialCd at J r , , ,C_/^r1JG I'C% % /J,, 1( ,../
1 (Address, Lo Block, Road, etc )
on M02fiyWeS f C/ GsK in �Ew 13E2N, C IZAL16W , N.0
(Waterbody) (Citylrown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no obiection to this proposal.
I have olaiectionss to this or000sa+
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
pndlv/daal proposing +devefapmenf must fill In dioa ftIptlon belo►r oro#wb a sits dMW107g)
w C to t iC
lzr Mov E
J�_ /.% 2 E A +0 6
b i2 5 06C O
42CA }'a
Der o&, r
I understand that a pier, dock, mooring'pffrigs, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riaarien acwss vniess +waived by
me. (d you wish to waive the setback, You must ifutir l the appropriate blank below.)
co wish to waive irte 'a& sexoaaR requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adiaoent Property Owner Information)
sef
wwure
Print JVame — .., _ � \ Print or Type Name
TWephoneNu brr/etnail•,nddrevs
yr
Date
Mailing Address
City/statelzip
G" /`'i Telepharx "f .tis�-W errral' 6 ass
Jbta r
(Revised Aug. 2014)
*Valid for one calendar year after signature*

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