67292D - Huntley

CAMA / ❑ DREDGE & FILL JZZ,
1, (� j�, NON 6,1292 A B
IENERAL PERMIT Previous permit #
{slew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environment and Natural Resources /� V 1
oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Rules attached..
Name 1 ' l ` Q r� Project Location: County_
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❑ OEA
fJ HHF ❑ IN ❑ USA ❑ N/A
❑;no�
Wyes
PNA yes /no
Subdivision
City ZIP_
Phone # ( ) River Basin
Adj. Wtr. Bodyt , r )
Closest Mal. tr. Body
` Project/ Activity
,• I ier Head Lin'"
ck) length `� X PRbPoSED
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atform(s) M
Platform(s) X ' )
t
ength
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id/ Riprap length
g distance offshc
ax distance offsh
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use/ oatlift ,
3ulldozing
ne Length
not sure yes
>rium: n/a yes
yes
Attached: yes
ling permit may be required by
I oral Plannin¢ Jurisdiction)

NC Division of Coastal Mgt. Habitat impact Computer Sheet
kpplicant:Tke kn �V14Vouj
)ate: `1
Permit #:
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measureme
ound in your Habitat code sheet.
labitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated fii
disturbance.
Excludes any
restoration any
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other
�I
WDredge
❑ Fill ❑ Both ❑ Other
(�
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
014
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both �] Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
)15-1

ent Proccessing Confirmation
received 1 10/21/2016
From (Name) Justin Huntley
of Permit Holder Justin Huntley
Number 2161
amount $200.00
le Permits No
Minor
Number/Comments GP 67292D
it or Refund/Reallocated TM/2857D

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Justin Huntley I
(Name of Property Owner)
property located at Lc` 15, Block 93-Y Long Beach on ,vest Pelican Dr.
(Address, Lot, Block, Road, etc.)
on Montgomery Slouq`= in a Is=an 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)
Drawings were provided
WAIVER SECTION
I understand that a pier, dock, mooring pi ing ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15'-frsni-my area of riparian access unless waived by
me. (If ou wish to waive the setback, yodmust initiakhe 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)
Signature
Dana Lutheran for Justin Huntley
Print or Type Name
5315 S Ccilege Rd, Suite E
(Adja�r Property,0,wner Infor tion)
nature *
Print or Type Name

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Justin Huntley
Address of Property: Lot 15, West Pelican Drive, Oak Island, Brunswick Co.
(Lot or Street #, Street or Road, City & County)
Agent's Name #: Dana Lutheran Mailing Address: 5315 S . College Rd.
Agent's phone #: [phone] Wimington, NC 28412
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 drawing the development
they are pro osing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. 1 have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http://www.nccoastalmana_qement.netlweb/cm/staff-listing or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.
5 1 do not wish to waive the 15' setback requirement.
(Property Owner Information) (Riparian Property Owner Informa ion)
�GtD..Z
Signature .Signature
Dana A. Lutheran for Justin Huntley
Print or Type Name
514 Daniels Street, Box 311
Mailing Address
Print or Type Name _
Mailin ddress
- > --,- % / -.P— _, .--

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Justin Huntley
Address of Property: Lot 15, West Pelican Drive, Oak Island, Brunswick Co.
(Lot or Street #, Street or Road, City & County)
Agent's Name #: Dana Lutheran Mailing Address: 5315 S. College Rd.
Agent's phone #: 910.228 . 1841 Wimington, NC 28412
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 drawing_the development
they :71
osing. A description or drawing, with dimensions, must be provided with this letter.
ave no objections to this proposal. ____ I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
availableathttp://www.nccoastalmanagement.netlweb/cm/staff-listingorbycalling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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)
Signature
Dana A. Lutheran for Justin Huntley
Print or Type Name
(Riparian Property Owner Informa ion)
We;
fJ��l
Signature
-,­ f4P�c.Q
Print or Type Name
514 Daniels Street, Box 311
1�__--

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