69289D - Sheffield

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DIVISION OF COASTAL. MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
Name of Property Owner:
Address of Property'
(Lot or Street #, Street or Road, City & County)
Agents Name #: -6 A +'v C ��(� y�l4 era Mailing Address: s"7 CCu�
Agent's phone #- 6 - - T � -G%� !J
Agent's -amsW
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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 proposing- A description or draw- jna, with dimensions, must be provided with this ette .
✓ I have no objections to this proposal. -I have objections to this proposal.
If you hale objections to what is being proposed, you must notify the Div,
writing within 10 days of receipt of this notice. Correspondence shouk (
taj
Wilmington, NC, 28405-3845. DCM representatives can also be conc U
considered the same as no ob"ection if you have been notified b Certil or /
oc
WAIVER SECTION
yr0�
understand that a pier, dock, mooring pilings, breakwater, bo:
back a minimum distance of 15' from my area of riparian acce,
wish to waive the setback, you must initial the appropriate bU
I do wish to waive the 15' setback requiremen
I do not wish to waive the 15' setback requir
(Property Own reformation)
Signa re VU
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Print or Type Name
Mailing Address +
(Adjac,
S
Print or TypalNdme
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Mailing NAddress.-tJ _ Jr -a ?T Y

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to c� I A aK S �?�c�� 's
(Name of Property Owrs
property located at 9 CJqu S9wR (Ik( JR ! C4 ,g-r�► R% C
(Address, Lot, Bock, Road, s c.)
on CC - Ce `-nnl4Qci41,Cq 4 in C£ct , N.C-
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location
l have no objection to this proposal.
l have objections, to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill p description below or attach a site drawing)
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Ji WAIVE SECTION' �P44 Af
erslnd that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back
minimum distance of 16' from my area of riparian access unless waived by me_ (if you wish to wan
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)
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signs -: -, C . & F "V 4 �
(Adjacent Pro eOwner Information)
Print or a ame
Al -,A inrr drfrlrc�oe . .
Unifinn dnrirnoo
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ADJACENT RIPARIAN PROPERTY OWNER STTF(J((IENT
I hereby certify that I own property adjacent to _5k
( me of Property YOwner
r us4w� (ttJ< i� "
property 14cated aCS t ,
(Address, Lef, Block, Road, ate-)
one (� Ce �rnmti aciL �N in V ��/�n�� c �, M C.
(Waterbody) (CitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
✓ I have no objection to this proposal.
I have otjections to this proposal..
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual pro posiing devQiopmentmust -fill fr description below orattaclr a site drawing)
I do wish to waive the i 5' setback requirement.
I do not wish to waive the 15' setback requirement.
(Prsoporty.Owner Information)
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DIVISION OF COASTAL. MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWN --ER NOTIFICATIONMAIVER FORM
Name of Property Owner: 5 v', � C • c-��+{ q L- '&'� _
Address of Property: Csiat r,,wql 19 NIC , /} Ci -
-- - (Lot or Street #• Street or Road, City & County)
Agent's Name #: 0 Y� . t N �r14 c Mani V Address: ' R
Agent's phone*
Aenfa_.*waid'
I hereby certify that 1 own property ad*ent to the above referencsd property. The individual
applying for this permii has deser b0d tD me as aht wrt Ordpe attached drawing the development
they are proposing. &r
Y have no objections to this proposal. Y have objections to this proposW.
if you have olyecfrorss to what is bean pps�oposscl, yW rnu9t n0 ft tine DiviW= of Coastal MMabemer)t (DC" in
within to tdaye of mooW of this nafte. Correepoaderlce should be mrfled to 127 Cararinat Drive Eart.,
WHmksgMn, IVC, 2rir405Ws. DCM nWms&watives can Wso be ean*wtedst 010) M-72M No response is
enow dared ow same as no o&ocdw if volt have been noiifited by CorEiNed MO
WAIVER SECTION
I understand that a pier, dolt, 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 initiml the appropriate blank below.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(&KY Ow nr nrinrmatiart) .
Signa&re.
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Print or Typo Name
,�"-7 Cyr lr,u, 4�
fluffing AddrM
aC4a1',
Sigtr«t'rrre
D/2- N�rr©J l�,/•`lfirtrr� d�a
Priest or Type Name
dbl s lleii a, )/J,�e- 4y
Maft S

fate:
LETTER. OF AUTHORIZATION
6 - 29. /�
.1 k C Wd li a rn S d�j authorize
Print - Property Owner / HOA Rep:
o obtain a building permit from AC Code Enforcement for
>n behalf of myself or agency for property located at:
(Print — Property Owner or Licensed Contractor Name)
i
Person obtaining permit
type of work
will be responsible for the work listed.
guu 6v-jZt- Dt5(0asAL_ af� Drce�, fa'L:s A4, gib C3�Ak Jyc� ���
Property Owner / HOA Rep Signature Date
Telephone Number
Sworn before me this day of

NC Division of Coastal Mgt. Habitat Impact Comr
Applicant: J0 V h S K� 14
Date: Qq I, 3 A 0 i -1
Describe below/ the HABITAT disturbances for the application.
# (' q"�- sl
All values should match the name, and units of measurement found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FIN
(Applied for.
(Anticipated final
(Applied for.
(Ani
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
dist
Habitat Name
Choose One
includes any
Excludes any
total includes
Exc
anticipated
restoration
any anticipated
rest
restoration or
and/or temp
restoration or
tern
temp impacts)
impact amount)
temp impacts
am,
SDredge
XFill ❑ 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 ElOther ❑

8/4/2017
Elizabeth Easley Wetherill
George Brake
BofA
4627
$200.00 GP 4606D
8/4/2017
F and S Marine Contractors
Susan Gross
PNC Bank
6475
$200.00 GP 69362D
8/4/2017
Allied Marine Contractors/Hal Fogleman
Todd Christiansen
First Citizens Bank
5831
$600.00 GP 69343D
8/4/2017
F and S Marine Contractors
Craig Goess
PNC Bank
6487
$200.00 GP 69378D
8/4/2017
Coastal Marine Piers Bulkheads LLC
Gerald Haves
Wells Faroo Bank
21575
$200.00 GP 69361 D