69135D - Padgett

' rt;

NC Division of Coastal Mgt. Habitat Impact Com
Applicant:�� l I
Date: C')6_1104 f' j �-
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
FI
(Applied for.
(Anticipated final
(Applied for.
(A
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
di:
Habitat Name
Choose One
includes any
Excludes any
total includes
E)
anticipated
restoration
any anticipated
re:
restoration or
and/or temp
restoration or
tei
ternimpacts)
impact amount
temp impacts
ar
Srl
VBoth
Dredge ❑ Fill ❑ 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 ❑

W 1 * ► • ► e ► J11. s JJIR
3me of Property Owner Requesting Permit: _-�O-ff4
ailing Address: ..��Q�aj7AL& 4C
lone Number:
nail Address:
ertify that I have authorized 4/ lj I/,(_ 6' 1m4rc 1./'C'
Agent / Contractor
act on my behalf, for the purpose of applying for and obtaining all CAMA permits
cessary for the following proposed development: �fJ,244 oA
my property located at llo
Ardp^ w':JL,L County.
W
uthermore certify that l am authorized to grant, and do in fact grant permission to
,ision of Coastal Management staff, the Local Permit Officer and their agents to enter
the aforementioned lands in connection with evaluating information related to this
mit application.
perry Owner Information:
Signatur
'k��
Prirk or Type Name
&Y-1-1
Title

UtL1YtK
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to (N�oPropevty ner)
-operty located at ' etc.)
(Lot, Block, Road,
a , N.C.
C �iGlt v � r-Ct�t/
n ' ►n — (Town andlor Cout►ty)
(Wate:rbody)
��--�� Llo� Mailing Address•
►pp1�t'e phone #�: �. oc_. ! iJ
-IQ has
described to me, as shown below' the development he is proposing at that location, and, I
lave no objections to his proposal.
------------------ ------------
---
."----__--D�C�PTION AND/OR DRAWING OP PROPOSED DEVEI,OPMEN
(To be filled in by property owner proposing development)
-)c5c e A4 "" _
L) -----------
-�- -- t
Signature
Mailing Address /���^
.Y , l 'T �1 - l _ .. � C— Print o�-Trype Name

MANU UtLlVt c .
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to s
(Name of Priperiy er)
property located at �/d ?) 21:-1 YL+t�_ �r
(Lot, Block, Road, etc,)
i
on cretjc- 4A 1�61V in -_Q L-Y, 5 1r , N.C.
(Waterboddy) �~ (Town and/or County)
Applicant's phone tl: 90-,-)7 Mailing Address: 120b
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
- - - - - ---------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)

fTAT! a WIRTH CARD, MA
NFAMMICIA 001AfTT
1. ARMY A. NNAi11111, .AA CERTIFY f
THAT THIS AAl► w ORARN IROER w
="ri i mo R All nUsuViivam: PLAT OF SLRVV FOR
T"If M RATIO IK PRECISION AA p
C&OXAT" AY IATITUN AM K-
PMTWA r
MUMMIES
UMMI III 110. METE TNRE TA` JERRY J. Q SUSAN T. PADGETT
AS SROKIff NOT AMMETER TED ARE AI*-
F ORaQN LIKE 0 ROM FRCP IR-
FOAyATIW fOINf) IN SOOEf IIfF[II-
EXCEA' LDT 1. BLOCK 1'•AAR", YAUPON VILLAGE
.n7Nf" w /LAUD AMP 09AL TNif M YAUPON BEACH. NORTH CAROLINA
se► G ,IANYARY 1
SM I THV I L LE TOWI SH 1 P BRUNSW I CK COUNTY
SCALE: 1" • ZO' JANUARV 54h. 1996
ao1D Na JOB NO: 96001 FIELD BOOK: YAUPON VI
A 20 10 0 20 40
o� iy
OF~ BY iRYANT P. SPRNM I- -%
-352
SEAL
LSEAL REVI= 03/731/W - AV= PPINOM HOUSE
IZA H RIVER MARSH
_1 ON)
_
HIGH WATER HPWC
NIt+ e
p NIP
to I
BLOCK 1 ` A AR A
9, 034 SQ FT
YAUPON VILLAGE
YALFAON BEACH, N. C.
MB 5 PG =7 S. C. R.
e. s•
r
N
N
C°''°IfG romw j
C v. ow 1
a �.
LOT 5
L07 3
v8
PROPOSED RESI OENCE
R
75' AEC LINE
Z
AWWif COC
AEC CALCULATIONS
T'
AEC AREA . 5, 302 SQ fTT
I. f aH
B. 5'
30N . 1s90.6 SQ FT
C NOT IN=13ED WEIaW'f:31
mG : 1100
� $a
rCL
^
NNiv rSEWIX TAP
30. 00' NIP'
--l-- N 40'SZ' 00"H 70. 00' iLr
CL
LL
C.
LL
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