67914D - Oak

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: VV T Permit #:
� �lI
Date:
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurem
found in your Habitat code sheet.
TOTAL Sq. Ft
FINAL Sq. Ft.
TOTAL Feet
FINAL fee,
(Applied for.
(Anticipated final
(Applied for.
(Anticipated i
Habitat Name
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration ar
restoration or
and/or temp
restoration or
temp impact
temp impacts}
impact amount
temp im acts
amount
Dredge ❑
Fill ❑
Both ❑
Other
—I
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both [❑
Other ❑
Dredge ❑
Fill Cl
Both M
Other n

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property: 1 Ith Place East Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
I have no objections to this proposal. _a 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
available at http •//www nccoastaimana-gement netlweb/cm/staff-listinq 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
1-1!
at Signure T
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
,Signature
Print or Type Name
4601 E Oak island Dr
Mailing Address
Mailing Address

11/17/2016
ate
Elizabeth W. Shook
Adjacent Property Owner
2948 Jeff Myers Circle
Mailing Address
Sarasota FL34240
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I,
The Town of Oak Island
Property Owner
Permit on my property at 1 Ith Place East Street End
Property Address
Itma�
Here
/ '-ANO
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have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405
Sincerely,
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465

11/17/2016
Date
James M. Harper III
Adjacent Property Owner
3534 Airport Road
Mailing Address
Southport. NC 28461
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at I 1 th Place East Street End
Property Address
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have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Sincerely,
David Kellv-Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
11 th Place East Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
I have no objections to this proposal. I have objections to this proposal.
11
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.nccoastalmanagement.netlweb/cm/staff-listing orby 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailing Address
Mailing Address

11/17/2016
ate
Ronald Buccarelli
Adjacent Property Owner
845 Adam Street
MailingAddress
Hollvwood. FL 33019
City, State, Zip Code
Dear Adjacent Property:
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This letter is to inform you that I, The Town of Oak Island have applied for a CAMA Minor
Property Owner
Permit on my property at 9th Place East Street End in Brunswick
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Sincerely, Wilmington NC 28405
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
9th Place East Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Ke
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
I have 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
available at http://www.nccoastalmanagemenLnetlweb/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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailing Address
Mailing Address

Postal Service'"
CERTIFIED 0 . i
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For delivery information,
visit our website at www.usPs.jom;7
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Certified Mail Fee
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$
Ext Services tx Fees (check box, add
F-etum Receipt Mardcopy) $
11 / 17/2016
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❑ Certified Mail Restricted Delivery $ A
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❑ L Adult signature Required $ Ltb
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Pamela R. Lemm ons
❑ Adult Signature Restricted Delvery $
Adjacent Property Owner
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Postage
8306 Newberry Street
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Total Postage d Fees
Mailing Address
$
Stokesdale. NC 27357
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City, State, Zip Code
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PS Form 3800, April 17SM-02-000-9047 See Reverse for Instru
Dear Adjacent Property:
This letter is to inform you that I, The Town of Oak Island
have applied for a CAMA Minor
Property Owner
Permit on my property at 9th Place East Street End
in Brunswick
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Sincerely, Wilmington NC 28405
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
9th Place East Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Mailing Address: 4601 E. Oak Island Dr
Agent's phone #: [phone] Oak Island, NC 28465
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.
I have 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
available at http://www.nccoastaimana_qement.netlweb/cm/staff-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
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)
_ G
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailing Address Mailing Address

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11 / 17/2016 0
ate
Dennis Deaton o
Adjacent Property Owner m
181 Plantation Drive
Mailing Address .n
Mooresville. NC 28117
0
City, State, Zip Code r`
Dear Adjacent Property:
This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at 6th Place East Street End
Property Address
7)Q— 10
have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041 ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Sincerely,
David Kellv-Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405

0.
.
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
6th Place East Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
I have 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
available at http://www.nccoastaimana_qement.net(web/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 15from 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.
(Pro erty Owner Information)
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailinq Address
Mailing Address

11/17/2016
ate
Richard A. Thompson
Adjacent Property Owner
3321 Cornish Place
Mailing Address
Charlotte. NC 28210
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at 6th Place East Street End
Property Address
Postal
i CERTIFIED oRECEIPT
m Domestic Mail OnlY
n-
ru Certified Mail Fee
Ln
N Ex1raservices 8 Fees (check box, add fee aaa��pp,�� e)
Return ReceipI(hardcopy) $
Return Receipt (electronic) $ ^ Postmark
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Adult Signature Required $ G � S
Adult Signature Restricted Delivery $ --�—
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Sent To
11-9
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C3 Street and o. or P Boxp�
l.Cc(��N- �C.L,t.----
Ciry State, ,�` `_ -, ^�
have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Sincerely,
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405
Mailing Address
Oak Island, NC 28465
^:t. nL-a- �:- / --

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
6th Place East Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
I have 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
available at http://www.nccoastaimanagement.netlweb/cm/staff-listing orby 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailina Address
Mailina Address

11/17/2016
ate
Jerome Bolish
Adjacent Property Owner
325 Varnamtown Road SW
Mailing Address
Su ply. NC 28462
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at Middleton Street End
Property Address
Postal Service'-
CERTIFIEDoRECEIPT
ru
Domestic
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Certified Mail Fee
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7etum Receipt (hardcopy) $
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❑ Certified Mail Restricted Delivery $
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Adult Signature Required $
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Adult Signature Restricted Delivery $
Postage
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Total Postage a d Fees11
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Sent To
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aii_Staie,- \ .-._
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have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041 ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Sincerely,
David Kellv-Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405

Uri
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
Middleton Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
I have 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
available at http://www.nccoastaimanagement.netlweb/cm/staff-listing orby 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailina Address
Mailing Address

r'
11/17/2016
ate
Grace G. Surles
Adjacent Property Owner
PO Box 4
Mailing Address
Linden. NC 28356
City, State, Zip Code
Dear Adjacent Property:
Domestic Mail Only
For delivery information, visit our website at www.tisps.ccm'
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Certified Mail Fee
�. 30
$
Extra Services & Fees (check box, add ree ap
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Sent To
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This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at Middleton Street End
Property Address
23P O6
Here
15o�-C-b
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---------------------------------
have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to
Sincerely,
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405
Mailing Address
Oak Island. NC 28465

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property: Middleton Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
I have 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
available at http://www.nccoastaimanagemenLnetlweb/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
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)
Signa ure
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailinq Address
Mailinq Address

11/17/2016
ate
Michael G. Mastronardy
Adjacent Property Owner
18 Swain Street
Mailing Address
Toms River. NJ 08755
City, State, Zip Code
Dear Adjacent Property:
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This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at 2nd Place West Street End
Property Address
`�Iostmark
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have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Sincerely, Wilmington NC 28405
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
2nd Place West Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
I have 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
available at http://www.nccoastaimanagement.netlweb/cm/staff-listing orby 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
�� )--, S K, (/"---_
Signa re
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailina Address Mailina Address

11/17/2016
ate
Peter M. Shane
Adjacent Property Owner
1330 Forsythe Avenue
Mailing Address
Columbus. OH 43201
City, State, Zip Code
Dear Adjacent Property:
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www.usps.comx;
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Retum Receipt (hardcopy) $ . 1
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This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at 2nd Place West Street End
Property Address
have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Sincerely,
David Kellv-Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
2nd Place West Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
1 have 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
available at http://www.nccoastalmanapement.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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Y
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailina Address Mailina Address

Postal Service`M
,Tl;:IFn MAIL® RECEIF
11/17/2016
ate
RJ Lutz Properties LLC
Adjacent Property Owner
6025 Victory Lane
Mailing Address
Concord. NC 28027
City, State, Zip Code
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Domestic Mail Only
For delivery information, visit our website at www.usps.com®.
Dear Adjacent Property:
This letter is to inform you that I, The Town of Oak Island have applied for a CAMA Minor
Property Owner
Permit on my property at 7th Place West Street End in Brunswick
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Sincerely,
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405
Mailing Address
Oak Island, NC 28465

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
7th Place West Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kell
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
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.nccoastaimana_qement.neVweb/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
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
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailina Address
Mailina Address

11/17/2016
ate
Fred H. Sansbury
Adjacent Property Owner
126 SW 4th Street
Mailing Address
Oak Island, NC 28465
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at 7th Place West Street End
Property Address
m
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have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Sincerely, Wilmington NC 28405
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
7th Place West Street End
Agent's Name #: David Kell
(Lot or Street #, Street or Road, City & County)
Mailing Address: 4601 E. Oak Island Dr
Agent's phone #: [phone] Oak Island, NC 28465
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.
1 have 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
available at http://www.nccoastalmanagement.net/web/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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
V L
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailina Address
Mailino Address

11/17/2016
ate
David Broach
Adjacent Property Owner
5000 Heathridge Ter
Mailing Address
Greensboro. NC 27410
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at 1 Oth Place West Street End
Property Address
m
Domestic Mail Only
r`
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Certified Mail Fee _
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Return Receipt (hardcopy) $
Retum Receipt (electronic) $
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have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041 or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Sincerely,
David Kellv-Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
10th Place West Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
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.nccoastaimanagemenLnetlweb/cm/staff-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
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
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailing Address
Mailing Address

I
11/17/2016
ate
Keith Trinlette
Adjacent Property Owner
8133 Waterford Drive
Mailing Address
Stanlev. NC 28164
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at 1 Oth Place West Street End
Property Address
U.S.
Postal
Service''
.f
CERTIFIED
MAIL®
RECEIPT
Domestic
Mail
Only
website
at www-:'sNs
For delivery
information,
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have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Sincerely, Wilmington NC 28405
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465
011

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
IOth Place West Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kell
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
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 athttp://www.nccoastaimanagement.netlweb/cm/staff-listing orbycalling 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)
Signa ure
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mnilinn Arlrlra.cc
Mailina Address

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11/17/2016
0
ate
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Danny C. Leonard
C3
Adjacent Property Owner
o
2002 West Beach Drive
r`'
Mailinq Address
m
Oa Island. 28465
City, State, Zip Code
a
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r-
Dear Adjacent Property:
This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at 20th Place West Street End
Property Address
U.S. Postal Service'"
CERTIFIED MAIL° RECEIPT
Domestic Mail Only
For delivery information, visit our website at wwmusas.zom
have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041 ,or by mail at the address listed below. If you wish to
Applicant's Telephone
RV • P Her�����
qk/�i �ni`I.NG
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405
Sincerely,
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
20th Place West Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
I have 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
available at http://www. nccoastalmanagement.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.
I do not wish to waive the 15' setback requirement.
(Pro pe Owner Information)
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailing Address
Mailing Address

Dostal Service'"
T11=1Fn MAIL® RECEIF
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11/17/2016
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ate
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Michael S. Becker
C3
Adjacent Property Owner
o
1070 Foxcliff Drive
r`
Mailing Address
m
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Mebane. NC 27302
City, State, Zip Code
a
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Dear Adjacent Property:
This letter is to inform you that I,
The Town of Oak Island
Property Owner
Permit on my property at 20th Place West Street End
Property Address
Domestic Mail Umy
For delivery information, visit our website at www.usps.com
have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Sincerely,
David Kellv-Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405
1';ti, c+�+o 7i„ ('-1.

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
20th Place West Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
I have 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
available at http://www.nccoastaimanagemenLnetlweb/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.
I do not wish to waive the 15' setback requirement.
(Propert Owner Information)
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailina Address Mailina Address

4
11/17/2016
ate
Nancy D. Tuchscherer
Adjacent Property Owner
4907 Crooked Oak Lane
Mailing Address
Char,
otte. NC 28226
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I, The Town of Oak Island
Property Owner
Permit on my property at 23rd Place West Street End
Property Address
Domestic Mail Only
O
O _ -
� C
fL Certified Mail Fee
E ra Services & Fees (check box, add iee� a oral
Retum Receipt (hardcopy) $ ''rk,
Retum Receipt (electmnic) $
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O Certified Mail Restricted Delivery $ O\' -Jl dWd\�
C Adult Signature Required $ Y
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have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Sincerely, Wilmington NC 28405
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
23rd Place West Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island, NC 28465
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.
I have 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
available at http://www.nccoastaimanagement.netlweb/cm/staff-listing orby 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailing Address
Mailing Address

11/17/2016
ate
Jane M. Clark
Adjacent Property Owner
1 Cliff Court Extension
Mailing Address
Southern Pines. NC 28387
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that I;
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The Town of Oak Island
Property Owner
Permit on my property at 23rd Place West Street End
Property Address
U.S. Postal Service
CERTIFIED MAIL® RECEIPT
Domestic Mail Only
For delivery information, visit our website at www.usps.com"'.
have applied for a CAMA Minor
in Brunswick
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact me at 910-201-8041
Applicant's Telephone
,or by mail at the address listed below. If you wish to
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Sincerely,
David Kelly -Town of Oak Island
Property Owner
4601 E. Oak Island Drive
Mailing Address
Oak Island, NC 28465
Tara MacPherson
NC Division of Coastal Management
Department of Environmental Quality
127 Cardinal Drive Ext
Wilmington NC 28405

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: The Town of Oak Island
Address of Property:
23rd Place West Street End
(Lot or Street #, Street or Road, City & County)
Agent's Name #: David Kelly
Agent's phone #: [phone]
Mailing Address: 4601 E. Oak Island Dr
Oak Island. NC 28465
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.
I have 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
available at http://www.nccoastalmanagemenLnetlweb/cm/staff-listing orby 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.
I do not wish to waive the 15' setback requirement.
(Prop e Owner Informati on )
Signature
The Town of Oak Island
Print or Type Name
(Riparian Property Owner Information)
Signature
Print or Type Name
4601 E Oak island Dr
Mailing Address
Mailing Address

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Area of Disturbance
3230 sq. ft.
95' x 34'
Town of Oak island Dune Rebuild 23rd Place West i�A Gam' Dune Profile
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Area of Disturbance
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145' x 35'
Dune Profile
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4,180 sq. ft.
110' x 38'
Cown of Oak Island Dune Rebuild loth Place West Dune Profile
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,rea of Disturbance
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Town of Oak Island Dune Rebuild 7th Place West Dune Profile
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Area of Disturbance
4,114 sq. ft.
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Area of Disturbance
4,120 sq. ft.
103' x 40'
Town of Oak Island Dune Repair Middleton Ave.
07 109
Dune Profile
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East Beach Drive
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Area of Disturbance Dune Rebuild
3,570 sq. ft.
102' x 35'
Town of Oak Island Dune Rebuild 6th Place East Dune Profile

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35'
Area of Disturbance
4,235 sq. ft
121'x 35'
East Beach Drive
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Dune Rebuild
Town of Oak Island Dune Rebuild 9th Place East Dune Profile
31
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35' East Beach Drive
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Area of Disturbance
2--7 to G 4,44+sq. ft.
79' x 35'
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Town of Oak Island Dune Rebuild l lth Place East p� M Dune Profile
31