66531D - Mangus

a CAMA / ❑ DREDGE & FILL
3ENERAL PERMIT I
flew ❑Modification El Complete Reissue El Partial Reissue
A
Previous permit #
Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
.oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC "l d
B
j,, ;,Ii I I ^ t' i Y,Rules attached.
t Name ►Y! v `` N '� �M '� GPI v , r✓{ i'1 kt �- Project Location: County
r
If U VF
n l t- o kd a- 11 l State Ni j ZIP 1 B'
E-Mail
ed Agent
Q
ON'A
❑ CWTA
❑ ES
❑ PTS
❑ OEA
❑ HHF ❑ N ❑ UBA
❑ N/A
❑ PWS:
yes!/ no
PNA ye no
Project/ Activity L (; f 6
Street Address/ State Road/ Lot #(s)
Subdivision M / P" I
ZIP S4 1
Phone # (` I '1 River Basin
Adj. Wtr. Bod AmN nat r
Closest Maj. Wtr. Body A )l
(Scale:
:k) length
itform(s)
igth
nber
i/ Riprap length_
distance offshore
x distance offshore
,ic yards
Length
ttached:
ig permit may be required by: I OAl H H LAk j.(, ❑
.ocal Planning jurisdiction)- 1 n i..i it i j A-L,

4 C,tttivision of Coastal Mgt. Habitat Impact Computer Sheet
.pplicant: �,nn
late:
{ �yinMQ I�IGt r11 U5
Permit#: Wssn�
escribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
Pund in your Habitat code sheet.
abitat 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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
V V v
Dredge ❑ Fill ❑ Both ❑ Other
13 2
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 ❑ Other ❑

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 3/21/16
Name of Property Owner Applying for Permit:
Wiliam & Emma Mangus
Malting Address:
264 Guyon Avenue
Staten island, NY 10306
I certify that I have aothoriaed (agent) David Logan to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) demo existing fixed pier and erect new fixed pier
at (my property located at) 2908 W Yacht Drive Oak Island, NC
This certification is valid thru (date) 12/21/16
X L� U r
Property Owner Sipature
31z�1��
Date

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: Bill & Emma Mangus
Address of Property: 2908 W. Yacht Dr oak Island, NC
(Lot or Street #, Street or Road, City & County)
Agent's Name #: _David Logan
Agent's phone #: [phone]
Mailing Address: PO Box 15
Wrightsville Beach NC 28480
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. A description or drawing, with dimensions, must be provided with this letter.
Initials I have no 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 ht(Palwww.nccoastaimanmement tietlweblcmistaff listing or by calling 1-888-4RCOAST.
iYo response is considered the same as no objection if you have been notified by Certified Mai!
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.)
nitials I do wish to waive the 15' Setback requirement.
(Property Owner Information) (Riparian Property Owner Information)
Signature Signature �
David Loan (Authorized Agent)
Print or Type Name
PO Box 1552
Mailing Address
> R A1�,t k OA v
Print or Type Name
St! L;bcAPY xd,
Mailing Address

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RETU����RECEIPT 1000 27,E $6.74
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R2304P118678 20
NIXIE 274 CBE 1 1azu4/"4/Xb
.ZB6B�°jT RETURN TO SENDER
I t- r NOT DELIVERABLE AS ADDRESSED
UNABLE TO FORWARD
BC: 28480155252 *0448-13189-25-45
11!111111-IIII11!1111I'lI'I'l11111114,111111111111111111111111 ifii111
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Mangus Fixed Pier Rebuild
2908 W. Yacht Dr
Oak Island, NC 28465