68000D - Mitchell

NC Division of Coastal Mgt. Habitat i;r'rilpact Compute-r Sheet
Applicant:
Date: vZ/ V '5(/l —/
Permit #: 0 'ow -�-"
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.
(Antidpated final
disturbance.
Exdudes any
restoration
and/or temp
impact amount
TOTAL Feet .
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts.).amount
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill Both ❑ Other ❑
3 Za
1
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both 0 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 Q Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson Dee Freeman
Governor Director Secretary
AGENT AUTHORIZATION FORM
Date: 1-19-2017
Name of Property Owner Applying for Permit: Name of Authorized Agent for this project:
Lewis Mitchell
Owner's Mailing Address:
132 Tarpon St
Holden Beach, NC 28462
Will Richardson
Agent's Mailing Address:
3235 Seacrest Ave SW
Supply, NC 28462
Phone Number ( 803) 609-0122 Phone Number( gin) 367-n335
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):
Installation of new vinyl bulkhead wall & misc. repairs
(my property located) at 132 Tarpon St Holden Beach, NC 28462
This certification is valid thru (date) 6-30-2017
A�-eL ay�mv 1)2-
Property (?Wner SignatuYe Date
09

�1 F%, t) eO dE
CERTIFIED NLUL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL INLAIN-AGEN ENT
ADJACENT RIPAR120- PROPERTY OWNER STATEMENT
I hereby certify that I own properly adjacent to Lewis & Dolly Mitchell
(dame of Property Owner)
property located at 132 Tarpon Drive
(Lot, Block, Road, etc.)
on Canal in Holden Beach , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: [phone] Mailing Address: 132 Tarpon Drive
Holden Beach, Ne 26462--
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-NND/OR DRAWING OF PROPOSED DEVELOPMENT:
(A'ndividual proposing development must fill in description below or attach a site drawing)
New vinyl bulkhead wall.
ii you nave objections to what is being proposed, you must notify the Division of Coastal Management (DCNI) in wri
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext. Wilmington, N
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)
"&c ml
Signature
Will C Richardson (Auth. Agent)
Print or Type Name
3235 Seacrest Ave
Mailing Address
Print or Type Name
1131 Olt ern �r .
Mailing Address
Supply, NC 28462

r
CERTIFIED MAIL -- RETURN RECEIPT REOL-ESTED
DIVISION OF COASMU INLkN AGEMENT
ADJA CENT RIPARLAIN PROPERTY OWNER STATEIVIEi�tT
I hereby certitr that I own property adjacent to Lewis Mitchell
s
property located at 132 Tarpon Dr (Name of Property Owner)
(Lot, Block, Road etc.
on Canal in Hoiden Beach
(Waterbody)
Applicant's phone #:_ 803-609-0122
(Town and/or County)
Mailing Address: 132 Tarpon Dr
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.
N.C.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT;
(Individual proposing development must fill in description below or attach a site drawing)
Installation of new vinyl bulkhead wall
If you have objections to what is beint.
g proposed, you must notify the Division of Coastal -Management CDCIND
within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext Wilmington N(
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
(Property Owner Information)
Signature
Will C Ric iard-gon(Auth Aqent)
Print or Type Name
-121 Seacrest Ave SW
Mailing Address
Supply, NC 28462
C� ert3' ti��
ormation)
Signature
Ed Ivers
Print or Type dame
4516 Grandfathers Way
Mailing Address
Charlotte, NC 28226