66587D - McCorison

:'LAMA / ❑ DREDGE & FILL
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3ENERAL PERMIT Previous permit#
4New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
prized by the State of North Carolina, Department of Environment and Natural Resources l
Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC n '4 • 1 7 c r
❑ Rules attached.
it Name Project Location: County 1 rw
S w h
v, Z 4V Street Address/ State Road/ Lot #(s)
StateA) zip 1iOk 6
E-Mail Subdivision t
ted Agent ^0 1 �? ry � �' i1 City Q u 4'1 S�f
(NA ty �. CC., ZIP S
❑ CW �fW ❑}ft [I ES N❑ PTs r Phone
River Basin l�{i�
❑ OEA ❑ HHF 6 IH ❑ USA ❑ N/A
El Pws: Adj. Wtr. Body n (nat
n
yes / ro; PNA yes / Closest Maj. Wtr. Body
If Project/ Activity
>ck) length ' x
latform(s) /'
Platform(s) I
angth J
amber
Ld/ Riprap length
g distance offshore;'
T
ax distance offshorft
hannel
bic yards_
np
ise/ Boatlift
'gull ozing
Wn
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not sure yes o
•ium: n/a yes
yes
Attached: yes n
ng permit may be required by: J-JV✓V1
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(A 1i-�i�l V� ❑ See note on back regarding River Basin r
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Local Planning jurisdiction) t?

MC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant: / " ` C l Qom► 36 Y­,
Date: U 0 ('146( C
Permit #: �� S g_'— C
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
Habitat Name
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
I impact amount)
temp impacts
amount
Dredge ❑ Fill ❑ Both ❑ Other
I
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 ❑
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 0
Other ❑

Webmail
Page 1 of
Webmail
Re: agent authorization form
From : [e-mail]
Subject : Re: agent authorization form
To : Wanda B brian grice <[e-mail]>
AGENT AUTHORIZATION FORM AGENT AUTHORIZATION FORM
Date: 19 July 2016
Name of Property Owner Applying for Permit:
Andrew B McCorison
Owner's Mailing Address:
215 William Penn Plz
Apt 1037
Durham, NC, 27704
Phone Number [phone]
[e-mail]
Tue, Jul 19, 2016 01:51 PN
Name of Authorized Agent for this project:
Grice Construction
Agent's Mailing Address:
Phone Number (
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):
Replacement of floating dock and ramp.
x my property located at 33 Union Street, Ocean Isle Beach, NC, 28469
This certification is valid thru (date)
Andrew B McCorison
Property Owner Signature
19 July 2016
Date
---- Wanda B brian grice <[e-mail]> wrote:
> I need this filled out and signed so that I can obtain permit on your behalf.
> Thank you
> Wanda Grice

CERTIFIED MAIL RETURN REC� PT REQUESTED
---- DIVISION OF COASTAL. MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: 1 ►r� -'t�+•�-
Address of Property:_rLJ _S�-�?_4'r1'}`�
(Lot or Street #, Street or Road, City & CounTy� --
Agent's Name#:Qr1tk Qz�%-,, Mailing Address. -
Agent's phonell:
I hereby certify that I own property adjacent to the above referenced property. The individual applying for
this hermit has described to me as shown on the attached_drawin�.the development they are proposing.
V�nve ao objections to this proposal. I have objections to this proposal.
If you have o4joctions to what is being proposed, you must notify the Division of Coastal
Management (I)CM) In writing within 10 days of receipt of this notice. Corresggnptenee. should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represento..I'voir can also be
contacted at [phone]. No response Is considered the same as no objection !f you been
notified by Certified Mail.
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.
do not wish to waive the 15' setback requirement.
(Property Owner Information) ( jacent Property r r Information)
Signatun? 'ignalru•e
��?. - r T
1 ►mt or Type Name PNnl Type
Mailing Address Marling Address
City/state/�'Ip 2 $t�(�� Cily/state 7
Telephone Ntrmher Telephone Number

CERTIFIED MAIL. • RETURN RECgIPT REQUESTED
----DlVtSION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONlWAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street #, Street or Road, City & County)
Mailing Address: 61%
C�S�� �►x.c�1, ..�(� 21�0�
Agent'sName#:QirktR Qzor-,
Agent's phone
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 proposing.
I have no objections to this propostrl. I have objections tp this propos ►l.
If you have objections to what. is being proposed, you musH►oflfy the Division of Coastal
Management (I)CM) in writing within 10 days of receipt of this notice. Co►'respon0ence•should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representofivo s can also be
contacted at [phone]. No response is considered the same as no objection ff you hV# been
notified by Certified Mail.
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 Prop rty Owner Information)
Sid 1, r Signallo
Print or Type Name Print or Type Name
Mt►ilinh Address
cityistFateizil) 2 �y0
Telephone Number
Mailing Address
C)�,eA
citylstate/zip
Telephone Number

Postal Service"' Postal
• , RECEIPT
CERTIFIED MAILO RECEIPT • (�
/• Only
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CH W 20 ru ; u
Certified MailFeeco Certified Mail Fee 7 7
4 $3.30 0470
$ 3.30 0470 m $ 11
11 Extra Services & Fees (check box, add fee aq�gprgp' te)
Extra Services & Fees (check box, add fee a ajf te) ❑ Return Receipt (hardcopy) $ i U ltt t
❑ Return Receipt (hardcopy) $ ¢t f I - I I I I ,.�
❑ Return Receipt (electronic) $ tit i tl a ❑Return Receipt (electronic) $ s . ��� Postmark
❑
— Postmark [I Certified Mail Restricted Delivery $ I 1 110 Here Certified Mail Restricted Delivery $ Here �
❑ Adult Signature Required $ t r i fti r
❑ Adult Signature Required $
❑Adult Signature Restricted Delivery $
f— ❑ Adult Signature Restricted Delivery $
Postage C3 Postage 4, II 47
7
$ ii.�n $ 07/19/2I116
Totai Postage and Fees 07/19/2016 Total Postage and F$6 47
$ $6.47 $ Yt
SORTt� S To
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PS Form r r.
COMPLETE7 See Reverse for Instructc
•N COMPLETE THIS SECTIONON DELIVERY
■ 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. �a,4 �. �u I C
1, Article Addressed to: D. Is delivra7t�m item 1? ❑ Yes
If YES,low: ❑ No
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3. Service Type
El Priority Mail Express®
❑ Adult Signature
❑T'^
Registered MaiI
9590 9403 0603 5183 4335 99
❑ Adult Signature Restricted Delivery
❑ Certified Mail®
❑ Registered Mail Restricted
Delivery
❑ Certified Mail Restricted Delivery
O Return Receipt for
❑ Collect on Delivery
Merchandise
2. Article Number (transfer from service label)
❑ Collect on Delivery Restricted Delivery
❑ Signature Confirmation-
7 01t 5 0 6 4 0 0 0 0 6 3 6 8 2
19 0 4 rioted Delivery
E.
Restrriicted ture Deliverylion
PS Form 3811, April 2015 PSN 7530-02-000-9053
■ 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:
Domestic Return Receipt
A. Signa
X ❑Agent
❑ Addressee
g. R ed by (Pri ted Nape) C. Date of Delivery
—ti )
D. s delivery acibress different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No

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