69060D - Munching

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COMPLETEj
■ Complete items 1, 2, and 3.
A Signature
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■ Print your name and address on the reverse
SO that we can return the card to you.
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X (� _ �� E3 Agent
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■ Attach this card to the back of the mailpiece,
or on the front if space permits.
❑ Addressee
B. Received by (Printed Name
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1. Article Addressed to:
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D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address
Uveda Gaudreaux
below: 0 No
14 Dolphin Point Ln
Hilton Head Island, SC 29226
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❑ Adult Signature ❑ Priority Mail Express®
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9590 9402 1912 6104 4429
❑ Adult Signature Restricted DeliveryEl Registered MaiITM
❑ Certified Mail® ❑ Registered Mail Restricted
0 Certified Delivery
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45
2. Article Number (Transfer from service label)
Mail Restricted Delivery El Collect on Delivery ❑ Return Receipt for
Merchandise
❑ Collect on Delivery Restricted
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7 016 1370 0000 4733 016 3
Delivery ❑ Signature ConfirmationrM
� In Insured
Mail ❑ Signature Confirmation
InsuredMail Restricted Delivery
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PS Form 3811, July 2015 PSN
(°ver$soo) Restricted Delivery
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7530-02-000-9053
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Domestic Return Receipt
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COMPLETE• ON DELIVERy z
■ Complete items 1, 2, and 3. w D
■ Print your name and address on the reverse A Signature 3
so that we can return the card to you. X -1" �I �' A gent
■ Attach this card to the back of the mailpiece, v
B. Received by (Printed Name) A dressee N
or on the front if space permits. ' A C. Date of Delivery
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1. Art.-.-_ ddressed to: ` N
D. Is delivery address ifferent from ite 41
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If YES, enter delivery address below: Yes
Stamey Taylor �[p No N)
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PO Box 261 W
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Lillington, NC 27546 co
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3. Service Type
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❑ Adult Signature
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❑ Adult Signature Restricted Delive
0 Registered MaiITM
Registered Mail Restricted
Delivery
2. Article Number (transfer from service label)
❑ Certified Mail Restr ctd DeliveryDelivery
0 Collect on De
❑
for -0
Merchandise
E3 Return lnfirmationTM
7 016 1370 0000 4733 0156
Collect on Delivery Restricted Delivery ❑ Signature Co�
1SUfed Mail ❑ Signature Confirmation o
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PS Form 3811, JUiy2015 PSN
Mail Restricted Delivery
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Restricted Delivery CD
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7530-02-000-9053
Domestic Return Receipt

• NC Division of Coastal Mgt. Habitat Impact Coml
Applicant: vb+'1 —1
Date: 0 q/-Z `l IJ
Describe below the HABITAT disturbances for the application.
All values should match the name, and units of measurement found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FI1
(Applied for.
(Anticipated final
(Applied for.
(Ar
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
dis
Habitat Name
Choose One
includes any
Excludes any
total includes
Exi
anticipated
restoration
any anticipated
res
restoration or
and/or temp
restoration or
ten
tem im ads)
impact amount
ternimpacts)
arr
Dredge ❑ Fil Both ❑ Other ❑
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Dredge ❑ Fill Af Both ❑ Other ❑
600
Get
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

AINGO-NaAA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date March 4, 2017
Name of Property Owner Applying for Permit:
Aaron Munching
Mailing Address:
123 Swordfish Dr.
Supply, NC 28462-1824
I certify that I have authorized (agent)
Joel Klass
to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) replace bulkhead
at (my property located at) 123 Swordfish Dr. Holden Beach, NC
This certification is valid thru (date) t. 0 f

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