71847D - Peelle

' )V'A'3?*55 11
Noma of ImdMdual Ci-yl Qc 1- L
Appl*i For Ps+Kait
Ad&M of PeapeM L-�S CA �ovl� ,fit cz�
tLot or Stew* 'Sttreot or RoaM
ff
'City and Cocmty3
hereby certify that i own property ad f anent to the above-mle, heed ptoptr•y- The indiv4im
990p7ng t0f this permit has desetibtd to M as shown on the Anwhed drawing the iey+tloernnrcbe19- --
are proposing. A dexr4v6*n vrdry vfn % ttcdimentom3; 39*6mle cro%;ded with *6 Wier
have 110 objecTions t0 this prWosa:
Ef you have objections to what is b4"l proposad, please ware rite Di%is un of CoO0161-
142114gemeat, 127 Cardlunl DHvo to nsku, Wilmington, NC 28405 or cal; 91?-796-72LB
witbin 10 days of rseelptof thls Roues. No rtsportse is considered the some as no 006CtionIf
You have been notified by Certified Malt.
WAMR SECTION
i undersmad rhat a pier, dock, ttmoring pilings, breakwater, oopt muse or boa, lift *%Mkset
bek o minimum distance of is, from my area of riparian access - unless lVaived b-. me. of yru
Msb to ""Oivt !"a satbnck, you mutt in 001 the appropriate blank below
. -1 L_ I do wish to waive the 13' setback reouire^-e--.
I A ish to wave the t 3' setback
0 ,1al kAdel
Print NameIV
q�b V-�aq-
Trleplwna Number with Area Code MCDENR

GUMMUCTON
sew Old Odom@ am NoPAW
'Vom * owwo
61 Fox
M�ccLLecr q 4-

' V*13 76155
?lama of Individual Applying For Pernik~
A,ft t of PropcM L+S CA
(Lot or Stntt 4, St mi or Rosd)
'City and Comfy)
hereby ccrdfy chat I owa properzy adjawrt to the above-referencea proper.}. The indivedwu
app0119 for this permit has data iW to Me as Shown on dw anached drawing Ine eievtiopRre,Rtwj
are proposing. A descrimien or drawing, with dimeoaions, should be crot-ided wi* *k kjjft
have no objections to this prv;gCsal
ff you have objections to what is Wat propoaad, pleas* write Me D1161silan of C060,61-
ivfso494aasa; 117 Cardinal Drivo UtMiM Wilmindton, '
e itiC 28405 or c:tk{ 41 0?96-71t5
witbia 10 days of receiptorthis Aotics. No reiportao is considered rbQ some as noobiect6nif
rau have been norifled by Certified Mali.
W &MR SECTION
E understand [hot a Pier, dock, awring pftp breakwater, goo.( !tuuse or boa: kilt mretkSet
hcka minimum distanee of is, from my area of riparian access - unless waived b% rne. (it you
%v'sb to wave t►le sotb"kk, you must initial the appropriate blank, beta%v
do wish to waive the I I- setback revore.
i do not \ ish to waive the 13' 3etbatk
yn NN iv r �Ld
Print Name— ��...
Telephone Number with Arco Cods r NRC5ft
..r....,,,, ,.,,.,_.

Dete R.—%.d
DO. Dapoalted
Check From Name)
Natty f PWmR Holder
Vendor
Check Number
Check
punt
Permit NumberAComntrtte
Receipt or Refund/Reallocated
Col—f
Col-2
COMnnn9
CdumM
Colun"
ColumM
Cp16mn7
columM
11/14/2019
Wayrm Smith and Son, Inc
Diane Deering
Jan Peelle
BUT
19648
$ 400.00
GP 071846D
Tmc rG. 9088
11/14/2019
American Marine Construction, Inc
First Citizens Bank
88848
$ 400.00
GP i71847D
Tmc mt. 9084
11/14/2019
Town of Oak Island
Town of Oak Island
BBBT
78514
$ 200.00
GP 074590D
Tmc ret. 9082
11/14/MI91
lWayneSmith and San Inc
1JImmle, Sanders
OUT
1 196471$
400.00
1 GP i718481D
lTm rct. 9085