69252D- Roderick

Allied Marine Contractors
6/29/2017fi
6/29/2017t
Will Richardson
6/29/2017
Logan Marine
Holden Docks & Bulkheads
_6/29/2017
6/29/2017
James or Debora Wallace
6/29/2017
Will Richardson construction
6/29/2017
Joseph Burge
6/29/2017
Joseph Burge
Kevin & Wendy Longenecker
Patricia Felmly
Edna Willis
Richard Roderick
same
Charles Gandee
James Correa
Crista & Jewel Owens
First Citizens Bank
5645
$200.00
GP 69256D
BB&T
6750
523
2689
$200.00
$400.00
$200.00
GP 69257D
GP 69147D
GP 69252D
Coming Credit Union
CresCo_m Bank
r Oa Fouks Bank
2557
$200.00
GP 69268D
BB&T
6757
$200.00IGP69248D
Capital Bank
Capital Bank
3054
3055
$200.00 GP 69258D
$200.00 GP 69242D

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: 0�ti1n�,v of Permit #:
Date: 0 h /� 61
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
I FINAL feet
(Applied. for.
(Anticipated final
(Applied for.
(Anticipated final
Habitat Name
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp .
restoration or
temp impact
temp impacts)
impact amount)
temp impacts)
amount
jkj
Dredge ❑ Fill ❑ Both ❑ Other
Z
2
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 ❑ 1
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑ .
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill ❑
Both ❑
Other ❑
Dredge ❑
Fill 0
Both ❑
Other ❑

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�,07l2004 13:20 910842989E
GREE } IM-DEE '?
PAGE BI
M • r i i Yj l i SiaZQ�
Name Of Individual Applying For Peralt--_ W rf b &�(C k
Address -Or ProPe Y= �� W C CID S lib fff r�cC ��% -
5
*'#, CLOt orJtreeL or Raetd,
I hereby ctrtify that I own- pragerty adjao-nt to the above-
"I"Inced property_ The individual applying for this perait has
described t4 jowm as Shcaiin an tho attwchod drawing the: develop &ent
till-Y ara ProPosing- A descrriptiau or drawing, with dimensions,
zhould be provided vltb this 2attQr_
I have no objections to this proposal.
I that a pier, dock, =coring pilings, b_-aa]cvater, boat
btaasft, lilt - MUSs , be aet back a etiniWm distance of IS-
fru t aripari
y area of an access unless vaiv4ed by eat. : (If you Kish
to TSraiv@ the setback, Yost JIgAd.- initial the appropxc3.ata blank
below-) i
i;_+do wish to waive the 15 f setback xQquirement_
I dQ not wish to waive the 151setback requirement.
a
rr3nt name�....�..�

y07l2004 19:20 9108429BOS HOLDEN H4LP�PAGE $1
k�
i 4 i r_i ► i -NV#f�
Name of Individual Applying For Permit-, 141cm
Address -Of Property: �� (a�0 �VIIAA
, -str'e!L or Roed,
I hereby certify tbat I own property ad jwc ant to- t:h* above-
remfewuucced property- The indi-vidual applying for this permit has
dasc Abftd t.o as as shavn on the attaches d drawing the dsvelapaent
ttmy are proposing. A description or drawing , with dimensions,
>Ichouled be provided vith this leRtter-
i/ I have no objections to this proposal.
I nxrciarstand that a pier, deock. aRooring pilings. braakwa:teer, boat
hed WAR, list _ - gust. be met back a minims distance of 15•
from my arena of riparian accesz unlrss vaived by arc. _ (If you Wish
to naive the setback, You W-41ir, initial the. appraprlwtte blank
below.)
I ,do wish to waive the 15 t setback requirement _
I do ngt wish to waive the 151sentback requirement_
'/ 7

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