67945D - Dunlap

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NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: 14-VIJV� -k KC4A 94 Q� Permit #. �-7
Date:
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 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)
W
Dredge ❑ Fill ❑ Both ❑ Other
2
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 171 Both 0 Other ❑

2/21 /2017
6dcKwd lC r
Marine
Construction
Inc.
Dunlap, 123
Soundside Drive,
OIB BB&T 2706 $200.00 GP 67945D SF rct. 3567D

North
Beverly Eaves Perdue
Governor
Name of Property Owner Applyir
lAlk
Owner's Mailing Address
A
— --
Phone Number
NCDENR
i Department of Environment and Natural Resources
Division of Coastal Management
James H. Gregson
Director
&Gt-NT-AU'TH0RlZATI0N FORM
r-
Date 1", .0
Dee Freema
Secrelat
for Permit Name of Authorized Agent for this project.
Agent's Mailing Address.
C, '44 5
11-7
Phone Number
I certify that I have authorized the gent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permit necessary to install or construct the following (activity):
—VA 114- (i ,J I'i I C f ; I I'-%f"ArW ,
(my property located) at
This certification is valid thru (dat
r IV Hot
Property O neSigna ur
11-5 -1 (k
Date

Q
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
a
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner b Div dtq_ L "�t
Address of Property
(t-ot ,fir S!reet s Street or noao t,rcy a County)
Agent's Name tt c'r, s 1 �, a S o _ Mailing Address --z'
Agent's phone k
I hereby Certify that I own properIq aalacent to the above referer-ced property The ►ndivid
applying for this permit has desvi"a to me as shown on the attached drawtng_the developm
they are proposing A description or drawnnq with dimensions dust pe provided with this lette
r
(, _,ia 1 have no objections to this hrvlx1.aI ha%c objections to this proposal.
11 you have objections to what is being proposed, you must notlly the Division of Coastal Management (DC1G
writing withln 10 days of receipt of this notice Correspondence should be mailed to 127 Cardinal Drive E
Mmington. NC, 28403.3845 OCN representatives can also oo contacted at [phone] No respons,
considered the same as no objection rf you have been notified by Cartiflad Mall
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be se
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 initiate the appropriate blanK below
N,4 "'7 1 do msh to waive the 15' setback requiremer•r S7/I, e—
I do not vrssr:.o wratve the ,., setback raaurre�,.2nt
(Property Own tn1ofnt8ti 1 (A cont Pro o wner Information
Signature Signature
i A n �1

J1 r' QP-A
Ab-r- l� 44-vrpk)
�s CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner anew �1 �, o� OZ Ll4 DtJIJ
Address of Property 12 3 Vl!�, aT-e>,
(Lot cr S!reet 8 Street or rroac ury ci County)
Agent's Name a p �1 7 Mailing Address 1 5ey % k"r
Agent's phone /ll� yy 7 ���
I hereby certify that I own property adjacent to the above referenced property. The individul
applying for this permit has described to me as shown on the attached drawing the developmei
they are proposing A description or drawing. with dimensions, must be provided with this letter
I have no objections to this propo-sal. I have objections to this proposal.
11 you have otjacdons to what is being proposed, you must nottly the Division of Coastal ManagemeN (om
writing withla 10 days of receipt of this notice_ Correspondence should be mailed to 127 Cardinal Ddve Fir
Wilmington. NC. 28405-3845. DCM representatives can also be contacted at [phone]. No ntponse
considered dw same as no objection tl you have been notified by Certified Mail
WAIVER SECTION
I understand that a prer, 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 Mow )
t do wish to waive the t 5' setback requirement
do not 4vtsh to v.?!`te tt+e ? 5' setbact: res;cslrt3r~eri
(Propert�r Own 4njoti }
Signaiurre
J- a, 4) (2 Ile I C--
(Adjacent Property Owner Information)
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