71856D - Fisher

AGENT AUTHORIZATION FOR CAMA PERMT APPUCATION
Name of Property Owner Requesting Permit: ,kc K •'• 1~
Mailing Address: SZq �L'eJT• �;r Cn 4c✓
C C%
ottone Number: T/-6.3 2-
Email Address: ��. 5a.�•� GSA' �jf z�: �• c-`
certify that I have authorized < !1 r• , i n t <• 11
iaent f Ccntraclor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development 1�_.,
at my property located at 2 (t 5 4.l i s t `' 5 '
in L r L-tcw. c.k County.
1 furthermote 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 "re aforementioned lands in connection with evaluating information related to this
permit applicaticra.
Property Owner Information:
Signature
Prinf or Type Name
Title
Date
This certification is valid through C' 1 30 1 Zo zr(]

CERtI :LD M. &L- '.-mow 0--7
j .Name of Property Owner
Address of Property:
(Lot or Suet A. Street or Road. Cit" $ Coun5",
Age, i's Name aj �; �' �Aaiting =,dare :
lo
Agent's phone t
I hereby certify that I own property adjacent to the above referenced: property. The individuai
applying for this permit has described to me as shown on the attached drawing -'tie development
they are proposing. A description or draavino. with dimensions must be provided wish this letter.
I have no objections to this proposal. _ I have objections to this proposal.
F, you have objections to tyhG is being Proposac{ you, nust nofry the Division ci Cori lii7anace ,Wert (DC,' ) in
tari*ffng oviWin 10 days of receip? oibRi Iotfco. r'oi—,espondencr should be maRed to `r27 Ca-rnai:-rive E-.L.
Mlmiagton, NC, 28405-38445. -')CM raor as YL-Sves can also ba contacreG at [phone]- No response is
considered the same as no objection yot, havba�n rotire_r 3y C: rimed
I understand that a pier, dock, mooring pilings, breakwater: boathouse, lift, or groin must be set
back a minimum distance of 15' iTom my area of riparian access unless waived by me. (if yOL:
wish to waive the setback, you Mws� lnilda! the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I Jo rot wish to waive the 15' setback requirement.
sites-.#
Print or 7 ype'Name
C -r z L•rj C c -t
Ma17irg Address
Cityllst telzlp
Telephone Number
0"� t '� - -- ---
Date
,i: ^.IyGLiC:... C:'3 W�L�:t•y �.. �►.i L:. .� �. �i ,
gi- -, �1, U 7r
Print or Type .game
i "A ? 21 -`- --x. da l e r� r
nfailin; Address
Telephone Number
/(- ZZ- t'q
v
Re,rised V &201

CEitiPI f:EQt] sTEi�
r
DIVISION OF COASTAL A9ANA('cMRNY
ADJACE?dT RIPARIAN PIROP£Sti71f OWNER N011FJCA7Ji0MW.ApIE31d t`(X,,gK
Marne of Property Owner:
Address Of Property. z r t <.j ) * 4 }
(Lot or Street #, skeet or Road, city 14 County)
Ageni's Name # t 'Li �"--t711t �Lj� Maims A1ddr�SSt: - 7 h {)r� .(% i lr l) t' i a .
Ack
Agent'sphone# y�U- aci"U IU `C�� 5�i14k:•� •t• {i t.c{`-j�'
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 dravAng_the development
they are proposing. &_description or drawing with dimensions must be nravided avith this led
!N I have no objections to this nwposaL I hove objections to this proposal.
Hyou have otrjecffons to wtmtls boing proPosod, ym+mustnab7ythe Dfvlsfon of coastuf mana9enuytf Q7CMJ in
wilting within 10 days of receipt of this Luce. Conespondwrco should be me0ed to 127 Carding► Drlvs Ext.,
WfJmiaytoa, NC, 28405.3M DCM representatives cm► elso be contaetod at [phone]..No respo"o M
Consldwed the same 4s tm otcnon 1f you have Been rrotl/ied by CanGfiad 1t0afl.
L� p � tern--1,-h-��..------�-----..,,..-....�....R^....
uOr'1 ER SECT 1V
1 understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 16 from my area of riparian access unless waived by me. (if you
wish to waive the setback, you must tourer the appropriate blank below,)
I do wish to waive the 15' setback requirement-
I do not wish to waive the 15' setback requirement,
{?ropergy Owner Inknmation)
ffiYrt or Type ante
Maiiitng Address
Cam_
Clt matorz p
Telephone Number
(Adjacent Prop rt j t wncr Informaxion
s;�rrafta•� p jj -
IC�I�� d l�iCr
Print or a Name
Malfing Address
City/Stat&ZO
01(b-
Telephone f mbeer
DWd
Revised W&2012

..Q

D.* Recdvad
Date Mari
Check Fmm !Name
Name or P~ Holder
V dor
Check Numlw
Check
ant
P—/I Number/Commonts
R—iM or Retund/Realloea(ed
Cok-1
Column!
Column3
ColumM
Cdumn5
Columns
Cdumn7
CdumnS
Column9
2/17/2020
CLTMC, Inc.
Zach Fischer_
First Citizens Bank
First Citizens Bank
1032
E
GP #71856D
GP #71857D
GP #74895D
GP #7_TD _
GP €/6227D _ _
IGP#748T7D
Tmac rct. 10978
2/17/2020
CLTMC, Inc.
Tommy Williamson
1031
_600.00
E 600.00
Tmac ret. 10977
Z/172020
H5 Construction, LLC
Vamams Docks & Bulkheads Inc.
Holden Docks & Bulkheads/ Holden
Edward Miller
_
BUT
2475
E 200.00
B8 rcL 11457
2/17/2020
Chris Mo an
_
88&T
7664E
Z00.00
BB ret.11456
2/17/2020
Lockwood FollyPO Inc.
CresCom Bank
3791
E 200.00
BB:11454
2/1720201
!Jerry Ennett
I John Schroeder
i Coastal Bank and Trust
2738
600.00
IJD rct. 10968