69174D - Glaspy

5/15/2017
Richardson
Archie Glaspy
BB&T
6710
$200.00
v V 111 ■11r11 l�
GP 69174D
Construction/Will
Richardson

NC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant: � Permit #:
Date: 6
/6// o c -7
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measuremen
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 fina
disturbance.
Excludes any
restoration andh
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other Ek
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 ❑

A LV-WA
NCDM
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
kwly Eaves Perdue James K G agson Dee RE
Governor DRecbr Sec
AGENT AUTHORIZATION FORM
Date: 4-17-17
Name of Property Owner Applying for Permit: Name of Authorized Agent for this project
Archie Glaspy Will Richardson
Owner's Mailing Address:
1224 Riverbend Dr SW
Shallotte, NC 28470
Phone Number( 90$-6720876).
Agent's Mailing Address:
3235 Seacrest Ave. SW
Supply NC 28462
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 consbW the following (activity):
Install boatlift and new pier for boat access.
(my property located) at 1224 Riverbend Dr. Shallotte, NC 28470

CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL, IbLA'NAGENIENT
ADJACENT RIPARLAN PROPERTY OW-YER STATEII.ENT
I hereby certify that I own property adjacent to Archie Glaspy
Game of Property Owner)
property located at 1224 Riverbend Drive SW
on Shallotte River
(Waterbody)
Applicant's phone #: [phone]
(Lot, Block Road, etc.)
in Shailotte
N.0
(Town and/or County)
Mailing Address: 1224 Riverbend Drive SW
Shallotte, NC 28470
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.
DESCRIPTION A `D/OR DRAWING OF PROPOSED DEVELOPMENT:
(Individual proposing development must fdZ in description below or attach a site drawing)
Boat Lift and new pier for boat access. (See attached drawing)
It you have objectioas to what is being proposed, you must notify the Division of Coastal Mpkaagement (DCl'1) in wi
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext. Wilmington, r
DCM representatives can also be contacted at [phone].
No response is considered the same as no obiection if You have been notified by Certified Mail
(Property Owner Information)
"rL Authorized Agent
Signature
Will Richardson
Print or Type Name
(Riparian Property Owner Information)
3235 Seacrest Ave SW
Mailing Address
1250 Riverbend Dr. SW
Mailing Address

' \.' I V t, 4.A
CERTIFIED IVIAIL — RETURN RECEIPT REQUESTED
DItiZSION OF COASTAL K-42NAGENYIENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Archie Glaspy
(Name of Property Owner)
property located at 1224 Riverbend Drive SW
on Shallotte River
(Waterbody)
Applicant's phone #: [phone]
(Lot, Block Road, etc.)
in Shailotte
N.0
(Town and/or County)
Mailing Address: 1224 Riverbend Drive SW
Shallotte, NC 28470
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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(Xndividual proposing development must fidZ in description below or attach a site drawing)
Boat Lift and new pier for boat access. (See attached drawing)
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in tiy1
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext. Wilmington, t
DCM representatives can also be contacted at [phone].
No response is considered the same as no obiection if You have been notified by Certified Mail
(Property Owner Information) parian Property Owner Information)
66t �& rL Authorized Agent �l 1
Signature Signature
Will Richardson
Print or Type Name
Patrick & Grace O'Brien
Print or Type Name
3235 Seacrest Ave SW
Mailing Address
1210 Riverbend Dr. SW
Mailing Address

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11 New pier for boat access
14
10k Boat Lift
N
5hallotte River