68074D - Mack

1CAMA / ❑ DREDGE & FILL
t
EN oMRALon PERMo Complete ITReissue
❑Partial Reissue
38074 A B
Previous permit #
Date previous permit issued_
sized by the State of North Carolina, Department of Environment and Natural Resources -oastal Resources Commission in an area of environmental concern pursuant to I SA NCAC OT [!)
. L � 6U � C-4 �) � ( t "o
�!,,,, Rules attached.
it Name Jok 0 I�n.Li.,�-K, Project Location: County klP w Rules
r'
�2q &-U U/1 P(A �Uk1 Street Address/ State Road/ Lot #(s) j�('a 01
6 State& ZI /
( ) (9UP 08
8E-Mail Subdivision (/fjj(,r V /tJILAA '
:ed Agent �(� Fire City_ (� E VI/(-!1�'llil�o ZIP 2�1
❑ CW t
'XPTA ❑ ES ❑ PTS P ne # ( 1) _ (3�Z River Basin Ck Or
ElOEA 1l' ❑ IH ❑ UBA ❑ N/A �`
Adj. Wtr. Body yi
❑ PWS:
/ no PNA yes /� Closest Maj. Wtr. Body
f Project/ Activity
ck) length ITOV
atform(s) I V 'J V
Platform(s) x W
ier(s) /
ngth
mber
d/ Riprap length V�
distance offshore ?:
uc distance offshore
cannel -*"'
bic yards
np
ise/ Boatlift f
ulldozing .',
e Length
not sure yes
ium: n/a yes
1
yes
kttached: yes 90
ng permit may be required by:
�Lf
(Scale: I
c-� %�',I�.{��
4N44 ❑ See note on back regarding River Basin r

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant:
Date:
Permit #:
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/ortemp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts
FINAL Feet
(Anticipated fins
disturbance.
Excludes any
restoration and/
temp impact
amount
ODredge
❑ 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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

Pat McCrory
Govemg �.
NCDENR
North Carolina Department of Environment and Natural Resources
N.C. Division of Coastal. Management
AGENT AUTHORIZATION FORM
Date: D 3/m r �VO
Nam of Property Owner Applying for Permit:
JObM I�nz�L,
Owner's Mailing Address:
Wes' z��1
Email: / {��
Phone Rp ) 6N)-0qA
John E. Skvada, III
Secretary
Name of Authorized Agent for this project:
LAlly
Agent's Mailing Address:
Icit if • /v.
R0 Box am
Wrightsville Beach, NC 28480
Email: [phone]
Phone ( )
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
b
For my property located at
to install or construct the following (activity):
YGr
f & �i/�arr �drtti�aata� /,ns.
This certification is valid 1 year from (date) �S/M v"
P.O. BOX 868
f Wrightsville Beach, NC 28480
[phone]
Property Oivaer Signature
-417� ��° " tot

lol: cg e

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: J D,s � rn�
Address of Property:
41hh?v)N �, 14,6, 2,9%V
(Lot or Street #, Street orRoad, City & Counf` )
Agent's Name*
�Cf' �'�G�/h� Mailing Address:
S�
Agent's phone#: qp-07��✓�- �ji%t"�v
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 repro ing. A description or drawing, with dimensions, must be provided with this letter.
I ha%e no un_jt}-�ctions to this proposal. I have objections to this proposal.
fzgAALd
If you have objections to what is being proposed, you must notNy the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405•3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION N%-
I understand that a pier, 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 below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Siglrarure
]OR- f#WL
Print or Type Name
53 , 12; SUw
Mailing Address
GIvlrrink} 14yl-, aq#
(Adjacent
Print or Type Name
/l 6 Eck 9 M!,).
Mailing Addriss
1* 0 4. C- -

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: �J 00, 1 iXX/Z
Address of Property:
(Lot or Street #, Street or Aoad, City &
,6 , 291
-1110, 1)`
g
Aent's Name* Lf' �'�G�jhtl Mailing Address:
�
Agent's phone * 1q p- ?Z 6 �✓ � (/V 13 "'� /Hy� Z�yB�
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 proposiith dimensions, must be provided with this letter.
h! I have no ub'--tions to this praposa I have objections to this proposal.
d you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) M
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION N/
I understand that a pier, 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 below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Prop yty ner I fl�natioa�
z-�7�tur�� _ S,•'�natnre
Print or Type Name Print or Type Name
IM_ailing Address MarOng,,Address 11 / �,�}