68067D - Doherty

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: 1" ov Y ► -c k 00
Date: p'Z, (71'7i0 i-
Permit #: 6 S'o(,-7-1)
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied. for,
Disturbance total
includes any
anticipated
restoration or
temp im�p+acts)
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
tern impacts)
mp
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
_
(� V V
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
1-wlh
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 ❑

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson
Governor Director
AGENT AUTHORIZATION FORM
Date: Feb 8 2017
Name of Property Owner Applying for Permit:
Patrick J Doherty
Owner's Mailing Address:
1816 Jumpin Run
Wilmington, NC 28403
Dee Freeman
Secretary
Name of Authorized Agent for this project:
Will richardson
Agent's Mailing Address:
3236 Seacrest Ave. SW
Supply NC 28462
Phone Number( 91 q 297-9572 Phone Number( 910 ) 367-0335
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):
Replacing floating dock and pilings at same location
(my property located) at 152 Sailfish Drive, Holden Beach NC
This certification is valid thru j(zl`ate) April 8, 2017
L�
Property Owner Signature Date

Chip Huffststler
N
Scope of Nork:
Remove and replace floating dock damaged during
Hurricane Matthew.
Float to be in pier head alignment with adjacent
property owners
Owner:
P J Doherty
152 Sailfish Drive
Holden Beach NC 25462
910-29--95'72
(Donald Barber
j; Replace floating c
Align with adjc

nA,1L—: P"xA k6c'A
CERTIFIED l IAIL — RETURN RECEIPT RF-LQ ESTED
DIVISION OF COASTAL NI L��i AGElYIENT
ADJACEItfi RI=PARLAOi PROPERTY OWNER STATEN ENT
I hereby certify that I own property adjacent to
P. J. Doherty
(Marne of Property Owner)
property located at 152 Sailfish Dr. Holden Beach, NC 28462
CLot, Block, Road, etc.)
on Canal , in Holden Beach
(Waterbody)
Applicant's phone #. [phone]
(Town and/or County)
Mailing Address: Wilmington, NC
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
is
N.C.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Individual proposing development must fill in description below or attach a site drawing)
Replace Floating Dock & pilings in same location.
If you have objections to what is being proposed, you must notify the Division of Coastal' Management (DCM) in writii
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive ErL Wilmington, NC
DCM representatives can also be contacted at [phone]_
No response is considered the same as no obieciion if You have been notified by Certified flail
(Property Owner Information)
ul)xcA�JM-
Signature
Willie C Richardson (Auth. Agent)
Print or Type Name
3235 Seacrest Ave
flailing Address
Supply, NC 28462
_Piparian Property Owner Information)
_—
ignatur
Chip Huffstetler
Print or Type Name
5546 Murrayhill Rd
Mailing Address
Charlotte, NC 28210

017 01:37p Sports Page 7043990408 p.1
C94�
CERTIFIED -m a T-r. — RE Ti,'R� RECEIPT RE Z STED
DIVISZO�I OF COASTAL K-A- AGEMENT
ADJACE 1-T RIPARIMN PRO?ERTY OW-IER STAT1TNT,,-T
I .here'oy cezt'fy that I own property adjacent to P. J. Doherty
's
ame of
Property located at 152 Sailfish Dr. Holden Bea h NC 28462 PropPrn� Owner)
on Canal (Lot, BloeIL Road, etc.)
C ---- l�l Holden Beach ,1F.C.
(�Vaterbod(Town and/or County)
Applicant's phone #: s100- 297-9572 MaDing Address. Wilmington, NC
He/She has described to me as shown below the development he/she is proposing at ti�l locaton,
and I have no obiections ,co the proposal
DESCRIPTION ANt-WOR DRA.NMr, OF PR©POSED DEVELOPiVlEl�IT
(Individual proposing devetaprnent must fit? in description below or attach a site drawrn;}
Replace Floating Dock & pilings in same location.
If you have objections to what is belIle proposed, you must uotUy the Division of Coastal 6Iana event Cl
within 10 days of receipt of this notice. Correspondence should be maned to i?7 Cardinal Drive Ext ) niy�C g
DCX, representatives can also be contacted at (9I0) 796-721s_
Nn resnanse is coasidere the same as no ob'ectton if You bare been notified b Cerii. ed Ma1
�Troperry Offer Information)
(Riparian Property pR-nerinformation)
Slgilat'ore
Signature
Willie C Richardson (Auth. Agent)
Print or Type Name
3235 Seacrest Ave
lylaiiing Address
Supply, NC 28462
City / State / Zip _
Donald Barber
Print or Type Name
104 Woodwinds Dr.
Mai ling Address
Mt. Holly. NC 28120
City / State / Zip