71857D - Williamson

of FNvv" tom,sty P,00tr �'►� YV ��i0.YYl5oa�
�L)
t�wrt+(v that t have authorrr ! �j'!1^i Lnue �1 Ti: c , YY�cN ►l'� C� nS�vuc
J r* r 1 _rrrAV %I irk*
to act on my tehart, for the purpose of apptying for and r"*%wV so r;AW o•orr 44
necessary for the tot,owinq proposed development bLal )4f
Fi �c HX, CAec)�, -, t1 CA Oakk
,at my property located at
w , County
furthermore certify that l am authonzed to grant. and do in fact grant perr. ussiw to,
Division of Coastal Management staff, the: Local Pen -nit Officer and their agents to enter
on the aforementioned lands in connection G.-ith evatuati;ng information re ated to `hS
permit application.
Property O rwr trtformat' n:
LVnature
7MCN)1-10
Pant or Type tti'arrr�
C'iuYi �l"
Title
)3 1,
Gate
'Pis certifications v3a�{� through 3_t ,� 3

ADJACENT RIPARIAN PROPERTY OWNER STATE/LENT
I hereby certify that I own property adjacent to s
Ls 11 (game of Property der)
property located at ��_ -i''t -fit-
O�G .S ! (Address, Lot, 0toc R�5,retc-) f
on .4- , in ,� N.C.
(Waterbody) (CityrTown and/or County)
The app' nt has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill In description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner I ation)
*1 klj� Aga -41z'
Signature natur
1z.
e
Pri t or Type Name Print or Type Marne
fob St,J I'
Ma ling Address
b-L ( c cc of N L a 8 Ll (,S
City/State2p
� 1()-5gl 0(�2Z
Telephone Number
Date
Mailing Address
City ate/Zrp
Telep e Number
Dale
(Revised 611812012)

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPE,R,TT1Y" OWNER NOTIFICATION/WAIVER FORM
Name of Property ov.,ner f�j G/�!(4,.
Address of Property. 1,5 4-11 56 1W, if atfC.{ v f it
,Lct 6r Street s, Street or Road, City 3 County) �)
Agent's Name # �hs^1.S 1-duc 11 Mailing Address y o �i `a ac �54-a
Agent's phone #. Q�tS' aZa�(-0� /tS SDU�f.L.f 5 q_c
I hereby certify that 1 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 devetopmen'
they areproposing A description or drawing. with dimensions, must be provided with this letter.
V I ha%-c no objection to this proposil. _ I have oh;cctions to this proposal
M you have objections to what is being proposed, you must notify the Division of Coastal Management tDCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Dnve Ert
Wilmington, NC, 28405.3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certified Mai;.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, It, 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)
V i do wish to waive the t 5' setback requirement
I do not wish to waive the 15' setback requirement
A(P�rVope�lwner Inform
Pnnt or Type Name L
Marling Address
Crty/statelzp
4 ! 0- 50 01AD,
Tefephone Number
Uvtc
(Adjacent "eJOwgiy Information)
Print or Type
w )SI'l
Afailing Address
oq. K 1 5 `a ram.. 2� c
CitylStatelLp
?e*—_ 74 7-16 3
Telephone Numbe
Date
Revised 6M&2012

Dr.N RecNwd
Dm Dpohod
Check From ame
Name of P~ Noldar
V rw-
Check Number
Cn.af
amount
Parmlf Numher/Cornmenn
RcW or Rmnd/Raa/beefed
Column!
Column2
Column3
Columns
C k-5
Columns
Ctlumn7
Columns
Co.1-9
2/17/2020
CLTMC Inc.
Zach Fischer
Tommy Williamson
First Citizens Bank
First Citizens Bank
1032
$ 600.00
GP f71856D
GP #71857D
GP $74895D
GP 874894D
Tmac rct. 10978
2/17/2020
CLTMC, Inc.
1031
$ 600.00
Tmac rct. 10977
2117=0
H5 Construction, LLC
Edward Miller
Chris Morgan
BB&T
BB&T
2475
7664
$ 200.00
9 200.00
BB rot. 11457
2117/20201
Vamams Docks & Bulkheads Inc.
BB rct. 11456
?l172020
Holden Docks & Bulkheads/GregHolden
Lockwood F PO Inc.
CresCom Bank
3791
S 200.00
GP f76227D _ _
BB rct 11454
2/172020
Werry Ennett
lJohn Schroeder
Coastal Bank and Trust
27381$
600.00
JGP •74877D
JD rct. 10968