69414D - Collins

CAMA / ❑ DREDGE & FILL *,l� I ��++ w
ENERL PERMIT IY Prrl evious permit ��`# A B C
Do
[ New AModification __Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources 'I
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC o 7/, , j oo i 7 k =
❑ Rules attached.
Applicant Name SO` ('0 Wo S - Project Location: County
Address % Q�) �j�r��� ?� Street Address/ State Road/ Lot #(s)
City �44 Ay �4 state ?-X ZIP � �� � y ZQ qL)" S't-_
Phone # (832-) 4 Z 3 - E-Mail Subdivision '—
Authorized Agent i a t� �fwC Dn, City j 1ZIP 1L!
Affected ❑ CW XEW 'PTA KES ;�r"S Phone # ( ) River Basin Iif/n,
[IOEA ElHHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body (D i ^(' C1XY_ (Ca /man /unkn)
❑ PWS: 1
ORW: yes /(no) PNA �e�/ no Closest Maj. Wtr. Body_. �� �[✓� �^% / �; iC �:",r
Type of Project/ Activity
Pier (dock) length L4 A I J
Fixed Platform(s) 8 X It.
Floating Platform(s)
Finger pier(s)
Groin length
tuber J
Bulkhe 7 Riprap length avg distance offshore
max distance offshortcli
Basin, channel
cubic yards _
Boat ramp
Boathouse/ Boatlift
� f I
It
x
(Scale: %r s Z.o' )
Beach Bulldozing
r
Other V+
�Ifr st I
Shoreline Length S
SAV: not sure — yes no
Moratorium: n/a yes no !� �, U.1�^� -) %Jr l
Photos: yes no
Waiver Attached: yes n J
A building permit may be required by: C.?�/�c��t See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) 1 ` t ! i - ( f
Notes/ Special Conditions 1 tS �: j (dy o, A n 7 N I L G Q a�n ci a t� 1` - C'F�A IE A� + I o CQ `
/' /r/
Agent or Applicant Printed Name
Signature W�wead compliance statement on back of permit
Gov -- z83�
Application Fee(s) Check #
Name
Signature C__)
- C3 �o i8
Issuing ate Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: 1.760 'a ,,,-,� e; j3L� jp
140z;�roLr 1 E�ccj� '7700S
Phone Number: k/ 99,Z
Email Address:
1 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: '" e w looc e
at my property located at 4,/t o 41-0 '�;,,:,-o-ef ISe,4e
in 4iw.r4--Y_'k 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 Owner Information:
(340.1 Ze5;A_ �.
ignaturre/e
A (� %rAi s
Print oif Type Name
0 C-vA!'JE- 4
Title
lei is , �.di
Date
This certification is valid through 6 1 / l

..
tA
North Carolina Department partment of Environment and Natural Resources
Pat McCrory Division of Coastal Management
Governor Braxton C. Davis
Director
AGENT AUTHORIZATION FORM
Date: / % _cl -/ 7
Name of Property Owner Applying for Permit:
tt:l L-6c rAJ
Owner's Mailing Address_
i 70
Phone Number -k
John E. Skvarla, III
Secretary
Name of Authorized Agent for this project:
Agent's Mailing Address:
Phone Number (h' S77_3 7jL
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
?q e�.c. 4'
For my property located at f/,47. �/c
This certification is valid thru (date)
447
Pro rty Owner Signature Date
127 Cardinal Drive Ext., Wilmington., NC 2m
Phone: [phone] FAX: [phone] Internet: www.ncmwaIMaqagerrWt.W
NonrthCarolina
Na&ia[&
An W21 OM t * l ArfimiAw Action Employa

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Coe L,,,' $s
located at �/ O �/0 i (Name of Property Owner)
property ST S s T lit" N 4L ",
(Address, Lot, Block, Road, etc.)
on , in S o,tsf* , N.C.
(Waterbody) (City/Town add/or County)
The applicant 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 AND/OR 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 Information)
_L /�' 4f- 61"
Signatu e
-'4t/ �OLG iitr
Print or Type Name
/7GoSuaFT /3L110
Mailing Address
1�d u�ja4 T£x rtS %7oG S
City/State%Zip
k3 - /,L 3 I
Telephone Number
/o-V•/7
MOM;
Print or Type Name
Zx- ,,ddI11�r
Mailing Addres r
��r ��i1 � d / 'Y
City/State/Zip
-.276 -,'y-s6
Telepho9ne Number
/a//, %/ 7
Date
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to --1 4w-/ _4 / ad 's
yob (Name of Property Owner)
property located at ��D f -7 l3cA�,+ /f'_ "t kla
(Address, Lot, Block, Road, etc.)
on 13L14I-Vi r G.reeov' , in rr icvillw.c,r, N.C.
(Waterbody) (City/Town and or County)
The applicant 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 AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
-34qt-v /3),,cAp
3 % 4 ACC) /B L+e-ay
ro O o
WAIVER SECTION
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signa
tom-/ CGLL /Gt�3
Print or T pe Name
/700 r 4L-tI47'4F
Mailing ddress
y' ro,( X 77d43-
City/S ate/Zip
Telephone Number/email address
ii-q-/7
Date
ent Property Owner Information)
�J� L= -
Signature*
4Daz.v � r) (jG \ 4 e r
Print or Type Name
752 Sim
Mailing Address
lic'rr--�v,,.,
City/State/Zip
5y� "3�t�-c 3 �-1 /�y„�•iyv`1k°�� Ireri2un.1�
Telephone Number/email address
l i - ct a o 17
Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to —S' COc. e'-1 k4 I
(Name of Property Owner)
property located at 'le .-�00yLg-
(Address, I,ot, Block, Road'tc.)
on /gL�rlZ" �icrre , N.C.
in rr sa.—y'z'��e� � d�.rsw��:� �'-
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
L I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
3` 3'
C'f O a a o a Q cc✓
13.&.rsscff,d
WAIVER SECTION
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.)
s� I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prope�rtty" Owner Information)
ignature
Coc i-jok
Print or T pe Name
1,700 9.,,,arr r
Mailingddress
ys %l1 r1 -Ty
City/S te0p
�3-Z� fL3� yi9
Telephone Number/email address
/y r9 -//%
Date
(Adjacent Property Owner Information)
'Signa re* d
C 1tv�a,—
Print or Type Name
Mailin ddress
City/State2ip
It 9- (OO(o Zits
Telephone Number/email address
U / , /.
Date*
(Revised Aug. 2014)
"Valid for one calendar year after signature*

/ O / .`/ li'7
13 4 czJ4 4d
028P/2 y.)- a Ya ' ST
g1 -sue 7-`1
4 DT </NE
�141
F
I� f�rP�R►c�N
�o7- 4-���
l3 ol-K
_ I
i
OT ITN L/o�ySr
L�Q yOT�
T S . G oLc

p
X WAY
G©LL��cis/��Sa
Vz- o 41 o -roY S--rlte e-7--
Sv�sl-r i3 j Nc
LN
'0 oFEssio,���2�=
SEAL
29208 =
:z chi°
1 �
' / VP
;z x ode
1�vpe'- 7WA&
4404rs
X 4kACZ&,r,
r
BRUNNER ASSOCS. INC,
901 SHORELINE DRIVE WE
SUNSET BEACH, NC 2846
910-575-6799

� rl�m YQ 2"ff S te�T
I
"me 7"ca
yr Wrp,E
x
41
r f _
5-0 0
,F d.
Ga v C . P P. A 2%oV fA,,
11 f 11
0A CAR
�nF�ssioti`
0,
�29
:Q
29 0 8
����N�INE.�P.••�ie`
q D Ftv��'
/1/5,6v W 0 oz� 714 KN'Tv
BRUNNER ASSOCS. INC.
901 SHORELINE DRIVE WEST
SUNSET BEACH, NC 28468
pm

A,
lop
A Ao
)e
0
SEAL
29208
'(31 N
7p . .........
BRUNNER ASSOCS. INC.
901 SHORELINE DRIVE WEST
SUNSET BEACH, NC 28468
910-575-6799

■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
19E/IY20 af4 C, /7/IOf�!SOr1
PO 66Y -S I130
1) 1! n ofi,-1 n. (- k 77i 7
A. Signet e
❑ Agent
X ❑ Addressee
B. Rec ved by (Printed Name) C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
II I IIIIII IIII III I III I IIII I IIIII I I I I I I I 3. Service Type ❑ Priority Mail Express
❑ Adult Signature ❑Registered MaiITM
❑ Adult Signature Restricted Delivery ❑ Registered Mail Restricted
❑ Certified Mail® Delivery
9590 9402 2191 6193 9028 03 ❑ Certified Mail Restricted Delivery ❑ Return Receipt for
❑ Collect on Delivery Merchandise
_ _ _ _ _ _ ry Restricted Delivery ❑ Signature ConfinnationTM
2.'_ 70162710 0000 7259 6375 00) El Signature Confirmation
;tricted Delivery Restricted Delivery
(over$5
-— — —
PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
0 rgc/r r� ;, At-,e 6(2
j .�.5 A Di%rl�9L /)fL-S e de.
A. Signature
X El Agent
❑ Addressee
B. Received by (Printed Name) C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
W if 2 a f 17 70.4
3. Service Type
❑ Priority Mail Express®
I
I
IIIIII
IIII
III
I
I IN
I IIII
II
IIIIII
(IIII
II III
❑ Adult Signature
❑Registered MaiITM
❑ Adult Signature Restricted Delivery
❑ Registered Mail Restricted
9590 9403 0235 5146 9958 53
Certified MailO
Certified Mail Restricted Delivery
Delivery
[3 Return Receipt for
❑ Collect on Delivery
❑Collect on Delivery Restricted Delivery
Merchandise
El Signature Confirmation T^
El Signature Confirmation
2. Article Number (Transfer from service label)
7017 0660 0 0 0 0 7488
3986 :strieted Delivery
Restricted Delivery
PS Form 3811, April 2015 PSN 7530-02-000-9053
Domestic Return Receipt
8
2i2222
00000
V
-Ivvv
O
N
mg
O
?
ci
ci
O
7
ti
H
C
c
2�
0
4.4.
d
>>>
n
N
n
�
n
C
'ZO
W
O
-
N
goo
3
N
7
11
0
Q
a
m
m
N
a
co
Cno00oW0_�
N
0
C)
3
3
W
c
c
0)
m
x
A
W
W I V
NNW
ACID
V
goo
N
fo
FA
Fn En
is
n
NNN0)N
0
0
0 0
0
00000
00000
0G)Q
0G)
vvvvv
ACO
0
CO
CA
v
2 (NO)
)f
vvvvv
0
1
C-mOWW0
CC/)rnCn0)
�wcW>,v,v,e
A
V
W �
Oo t0
N
vvvov�
W
t
R
a