69085D - Weigand

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i CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
i� Iew -__.Modification ❑Complete Reissue ID Partial Reissue
A B C
Previous permit #
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 2 c'
❑ Rules attached.
Applicant Name :A MIZV Wr-IGAWD
Address
City State ZIP
Phone # (-If 0) S4 Z - $ tc59 E-Mail r C.1, vJ C Q aol . eor�
Authorized Agent WILL. RKIAAT,C,S�N
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C*TA
❑ ES ❑ PTS AGT
AffectedEl
AEC(s): 1-1OEA
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❑ IH
❑ UHA El N/A
ElPWS:
ORW: yes /ho
PNA
yes /
0
Project Location: County E V_%& "j S w i C K
Street Address/ State Road/ Lotj #(s) 3 5 q
J'�R�-NITy C.--ANE
Subdivision
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City �ow>r)y B�'Ac%A ZIP 2 84 (s Z
M'hone # ( 9t0) 1- 0335 River Basin L.:AM(SCiz
Adj. Wtr. BodyA f W W a�unkn)
Closest Maj. Wtr. Body A 1 W W
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Agent or Applicant Printed Name
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a I ' 1 it v)C
Signature Please read compliance statement on back of permit*
-4f— 7 311
Application Fee(s) Check #
RC
Permit Officer's Print�Named
Signature /Zo
AII �s'lll �201�
Issuing Date Expiration Date

I hereby certdy that I own Property adjacent to Richard Weigand
s
property located at 359 Serenity Lime {Narn+r of Prop" Owrww)
on AI' N%l (Address, 4fb&en lt�aRc4Cst 2
(Wady) . N.C.
(CityrTown and/or County)
The applicant has described to me. as shown below, the development propoeed at the above location.
itial here I have no objection to this proposal,
----_____ 1 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)
Replacement of floating dock
WAIVER SECTIQH
I understand that a pier, dock, mooring pilings, breakwater, boathouse. It or groins must be set back ,
minimum distance of IS' from my area of riparian access uriess waived by me (if you wish to waiv,
the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
t either
I do not wish to waive the 15' setback requvwnent.
(Property Owner Information) 11-0 d Prol" Owlt'Mt ildm Lott)
Signulure S19M
Wit! R�►ardson Authonzed Agent k �'*
Print or Type Nerve Print or T)pe 44m
3235 Seacrest Ave SW 14 43 -Z Vr ACTS-y a,
Mailing Address 1g Addrs3,s
Supply NC 28462 _1��"O -srT jv- t 1 2 8 -LAI
City/5tal&Zip City,
910-367-0335
rtouphone Number T
4-2-a 2
Burr Dare
04viled WI N012)

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AGENT AUTHORiZATiQN E0 CAMA PgRMIT APPLICATION
Name of Property Owner Requesting Permit: Richard Weigand
Mailing Address: 359 Serenity Lane
Holden Beach NC 28462
Phone Number: 910-842-8659
Email Address: [e-mail]
I certify that 1 have authorized Will Richardson Richardson Construction
Agent / Contactor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development. -
Replacement of floating dock
at my property located at 359 Serenity Lane
in Brunswick County,
l furthermore certify that / 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:
� Signature
C,t-
Print or Type N ,
DL'"'M el-.1,
Title
Date
This certification is valid through 1 l