76115D - Glenn

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r CA.MA / DREDGE & FILL NO. 76115 A B C
6 GENERAL PERMIT Previous permit#
4 /A Nevi ❑Modification CiComplete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality / U
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC OR H . I
❑ Rules attached.
Applicant Name nn .. 12,1 n Project Location: County
Address o�M,, (c,-.I Street Address/ State Road/ Lot #(s)
City V,'A �N StateA_(_ ZIP "2 L ❑y
Phone # Subdivision
Authorized Agent G .c�� �. ; / j City JCe �'.t t �� ZIP
Affected ❑ CW U EW K_PTA ElES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes PNA yes / (16::�-)
Phone # (
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application ee(s) Check #
uc`L
Permit er's Printed Nam
Signature
`1 1 D-1 Zv z 0 �' )-Z 2 u Zd
Issuing Da Expiration)Date
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: J�
---- --
Mailing Address:
Phone Number:
Email Address:
8 0 rt 614 r.,- S +r Q.+-
Occ.ax We- 0 C 28q
Q,q_LIC_61-T5
I certify that I have authorized�r_s,c)
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
in 15&n5w 44k County.
1 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:
OwnC r
Signature
rint or Type Name
Title
f Za 20
Date - -
This certification is valid through V` �V��

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROP1!ItTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: dem i C\Aa G t, i '
Address of Property:
(Lot or Street #,
Agent's Name#:GrICE
Agent's phone #: %o- s—n - a5
or Road, City & County)- --
Mailing Address:m1.3 COA ►.mac"
�n]�Slu �Wc NC 2,6%q
I hereby certify that I own property i djacent to the above referenced property. The individual applying for
this permit has described to me as shown on the attached drawing —the development they are proposing.
I have objections to this proposal,
If you have objections to what is being proposed, you must notify the Dlylabn of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Co should bd
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM rep res also be
contacted at [phone]. No response is considered the some as no objection been
notNied by Certified Mall.
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 gust Initial the appropriate blank below.)
t,
requirement.
W- I do not wish to waive the 15' setback requirement.
(Property Owner information)
Rid C4q�h't�
Signature
Print or Typ'd Name
( 2. r'S1Q A0%b&P r�\c)cta
Mailing Address
?-�A\ t%ao \ t4C 2-76R -1622—
City/Stafe—alp
%R- U4- 62-15
Telephone Number
3-z-2-k) ,
Date
(Adjacent Pro rty Owner Information)
Signature % ('
(1ldl-le 5 _62 [ r � �J
Print or Type Name i
Mailing Address
L2V— 162-63,
Telephone Number
_ 3—
Date
- Revised 611812012

U.S.
Postal
Service""
CERTIFIED
MAIL°
RECEIPT
Domestic
Mail
Only
For delivery
information.
visit
our
website
at www..Msps.com'.
Certified Mail Fee
#3.5,r
0406
=-
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$
02
Extra Services &Fees (check bar add lee 1p c'are)
[I Ret= Receipt (a hnfoopy) $ I
O
❑ Return Receipt (electronic) $ #0.00
Postmark
0
O
❑ Certified Mall Restricted Delivery $ $ 9 . 99
❑ Adult
Here
ED
Signature Required $ _
❑ Adult Signature Restricted Delivery $
Postage
$ $0.55
,n
03/03/2020
Total Posta"and Fe ss
C3
* $6.95
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■ Complete items 1, 2, and 3. A. Signature
■ Print your name and address on the reverse X� `;����� ❑ Agent
so that we can return the card to you. ❑ Addressee
■ Attach this card to the back of the mailpiece, B. Received by (Printed Name) C. Date of Delivery
or on the front if space permits.
1. Article Addressed to:
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
III
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Service Type
❑ Priority Mail Express®
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❑ Adult Signature
❑Registered Mail-
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9590 9402 2219 6193 1037 00
❑ Adult Signature Restricted Delivery
rtified Mail®
❑ Registered Mail Restricted
Delivery
❑ Certified Mail Restricted Delivery
11Nletum Receipt for
❑ Collect on Delivery
Merchandise
2. Article Number (Transfer from service label)
❑ Collect on Delivery Restricted Delivery D Signature ConfirmationTM
7 017 0660 0000 7487
I Delivery
1457 I Restricted Delive
lion
Signature Delivery
;iestricted Delive
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt—,

KA ? u:_. i.k i i _ �
a
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: inn i nc1S V1enn '
Address of Property: vi
(� (Lot or Street�
Agent's Name t r ict
Agent's phone #: %D" 5-7, : pUca _
or Road, City & Counter) ----
Mailing Address►✓t`"
n:TA5lu 5" NC Z�y aG
1 hereby certify that I own property i idjacent to the above referenced property. The individual applying for
this permit has described to me as shown on the attached 4nawing_the development they are proposing.
I have objections to this proposal.
ff you have objections to what Is being proposed, you must notify the DI of Coastal
Management (OCM) In writing within 10 days of receipt of this notice. Co r should the
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28408-9845. DCM repress also be
contacted at (910) 796-721& No response Is considered the same as no objection bleen
notified by Certified Mail
- _ ri�Yl�lu+.+A.
WAIVER SECTION
1 understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set bads ai
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 not wish to waive the 15' setback requirement.
(Property Owner Information)
�A"
Signature
".ems � 1e� r
Print or Type Name
c)cta
Mailing Address
City/Stetwip
%Ck— u- U235
Telephone Number
Date ---- `�---
(Adjacent Progerty Owner Ir
ignature
Print or Typd Name
7 G Z )- A/i d,t ., r
R e <. c L Le
Mailing Address
(�,1r
Nc �-io
City/statemlp 10
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Telephone Number
Date

•. For delivery information, visit our website at www.usps.com
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WILMINGTONr NC 28409
Certified Mail FeeEU t3. n4CIb
$ n-
r%- Extra Services & Fees (check bo r, add feeate)
❑ Return Receipt (hardwpy) $ �U lrV
p ❑ Return Receipt (electronic) $ Postmark
o ❑ CertKed Mail Restricted Delivery $ Here
O ❑ Aden signature Required $$0.00—
r-3 ❑ Adult Signature Restricted Delivery $
Postage $0.55
Total Postage and Fees U3/03/2lIZu
o $ $6.95
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m J No 6 0 Box
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■ Complete items 1, 2, and 3. r/
■ Print your name and address on the reverse X IUZ
so that we can return the card to you.
■ Attach this card to the back of the mailpiece, B. Received by
or on the front if space permits.
1. Article Addressed to:
r Q Lz6Y
❑ Agent
❑ Addressee
C. Date of Delivery
D. Is delivery address different from item 1? 0 Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Priority Mail Express®
I
III
II III
II
I II I
I II
I
III
I III
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❑ Adult Signature
❑Registered MaiITM
❑ Adult Signature Restricted Delivery
❑ Registered Mail Restricted
9590 9402 2219 6193 1036 94
4
IMPCertified Mail®
Delivery
El Certified Mai) Restricted Delivery
-Return Receipt for
❑ Collect on Delivery
❑ Collect on Delivery Restricted Delivery
Merchandise
Signature ConfirmationTM
❑ Signature Confirmation
2. Article Number !Transfer from service label)
71117 0660 0000 7487
1464 stricted Delivery
Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt

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Check From Nunn
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