68078D - Slapak

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(Name)
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Comments
2/28/2017
Maritime
Frances Slapak
CresCom
2410
$200.00
GP 68078D
SF rct. 3569D
Coastal
Bank
Construction
LLC

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: 2t�n GAS
Mailing Address: �`6fMtd%!n%!/t e 1,2A
Phone Number:6y
Email Address: %%�� /
I certify that I have authorized AY1 ,1_L u ,/` 46440zlt
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
I—// '-- /
necessary for the following proposed development: 1� �/AIlaX7,0
at my property located at
in County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
ignature
Print or Type Name
Title

Maritime Coastal Construction
1957 Stone Ballast Way Ocean Isle Beach, NC 28469
Tel: [phone]
Email: bill(-bmaritimecoastalconstruct] on.coM
Website: Maritimecoastalconstruction.com
Dear Hawkeye I I I property owners at 411 01' St. Sunset Beach,
Thank you for taking time to review the riparian neighbor notification documents for the building
of a proposed boat lift for your neighbors Mike and Fran Slapak. Enclosed is the adjacent riparian
property owner statement which CAMA requires to have filled out for permits. The town of
Sunset Beach allows for 5 ft. of setback from the neighboring projected boundary for the building
of piers, docks, boat lifts etc. However CAMA has a form which I have sent to you that must be
initialed and signed before CAMA will allow the building of the boat lift inside their 15 ft. setback.
The drawing shows that the lift will be inside the 15 foot setback by approx. 7 feet on your side of
the riparian corridor. It is a general practice for neighbors to waive the 15 ft. setback so the
neighbors can enjoy a dock and a boat lift. This practice reciprocates as I have seen many times and
the Slapak's would be very much pleased with your cooperation. Please initial the I do wish to
waive the setback requirement area and sign the form where indicated. If you have any questions
please call me at the above number and I will be happy to speak with you. I thank you and the
Sutherland's thank you also. Also, if you ever need any help with your waterfront please allow us
to confer with you and quote you on any work.
Sincer ,
Bill Thomas
Maritime Coastal Construction
1957 Stone Ballast Way
Ocean Isle Beach NC 28469
910-880-1921

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 44w/ SA-$2 A/C 's
4//-) 9 /1-7, (Name of Property Owner)
property located at 77
on aov?A-1
(Waterbody)
The applicant has described
to
(Address, Lot, Block, Road, etc.
in SG�/t Se7� Xl4C
(City/Town and/or County)
N.C.
to me, as shown below, the development proposed at the above
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
//ex.57-e
5(fG a e oc zw-'el ild�
WAIVER SECTION
understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived by
We,u 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)
ignature
Print or T e Name I)
/�_ W I i,-e I)AI
(Adja nt Pr rty Owner Information)
i n e*
A.
Prin,Z 0 TM, Name / '

■ Complete items 1, 2, and 3. &'' tb
■ Print your name and address on the reverse X ' r
so that we can return the card to you.
e ei Recvd
■ Attach this card to the back of the mailpiece, B. (Prl Name)i
or on the front if space permits. Vt"I i 7 ��C t'�r
1. Article Addressed to:
Zwk'ey 1l/ --<n imp,-ise-5 LZ C
��S7tover� ��
II I fI�I�I IIII ('I I II II I I I�'lllll I I II III ( I
9590 9402 1661 6053 1856 64
2. Article Number (Transfer from service label)
7016*0910 0002 1223 2075
PS Form 3811, July 2015 PSN 7530-02-000-9053
■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Jjo+rneS
020 V G- (fona 4
2, 41/
IIIII�IIIIIII IIIIIIIII IIIIIIIIII IIIIIIII�I
9590 9402 1661 6053 1856 57
D. Is delivery address different from iten
If YES, enter delivery address beloti
3. Senfice Type
C Pr
❑ Adult Signature
❑ RE
❑ Adult Signature Restricted Delivery
❑ RE
❑ Certified Mail®
DE
❑ Certified Mail Restricted Delivery
❑ RE
❑ Collect on Delivery
M�
❑ Collect on Delivery Restricted Delivery
❑ Si
M 1 cured Mail
0 Si.,
ured Mail Restricted Delivery
RE
a $500)
2. Article Number (Transfer from service label)
7016 0910 0002 1223 2068
PS Form 381 1, July 2015 PSN 7530-02-000-9053 --
Dome
B. Recei a nn d Name)
L
D. Is delivery address different from item
If YES, enter delivery address below
3. Service Type
❑ Pn
❑ Adult Signature
0 Re
❑ Adult Signature Restricted Delivery
❑ Re
❑ Certified Mail®
De
❑ Certified Mail Restricted Delivery
❑ Re
❑ Collect on Delivery
ME
❑ Collect on Delivery Restricted Delivery
0 Sic
❑ Insured Mail
0 Sic
Mail Restricted Delivery
Re
500)
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NC Division) of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Permit #:
Date:
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.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet .
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
I
DVv
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 Q Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to �jAeC .cam
property located atST
�4j (Name of Property Owner)
(Address, Lot, Block, Road, etc.
on CG�H�� in L51, re/- tack , N.C.
(Waterbody) (City/Town and/or County)
/ The a plicant has described to me, as shown below, the development proposed at the above
X�I
have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND10R DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
//Of X.57,e See aiT c, C-o-/ GJ/1
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
e must be set back a minimum distance of 15' from my area of riparian access unless waived by
me. (I y u 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) (Adj nt Pr rty Owner Information)
ignature ign e*
Print or Type Name �A Print or T Pe Name
1.S-3 V t a�rper w / t+e JAI 7 n 7 /_ // > . , ta-