69202D - Snug

*CAMA L_j DREDGE & FILL
GENERAL PERMIT VA Previous permit # A B
11
JNew —Modification E]Complete Reissue El Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources
3M!Yr1VonP%an aT nv'r ental co
-oastal Reso!5 M concern pursuant to 15A NCAC 0 12- aV
-70 EJ Rles attached.
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ig permit may be required by: .TOk.,Pl Of U14A 62 0 See note on back regarding River Basin r
-ocal Planning jurisdiction) - - . . - I

5/19/2017
Wayne or Julie
same
USAA
2443
$200.00
GP 69202D
Randolph
Federal
Savings
Bank

NC Division of Coastal Mgt. Habitat Impact Coml
Applicant: �—aAAO
VA —
Date: LI%4l /l I
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
FIB
(Applied for.
(Anticipated final
(Applied for.
(An
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disl
Habitat Name
Choose One
includes any
Excludes any
total includes
Exc
anticipated
restoration
any anticipated
res
restoration or
and/or temp
restoration or
tern
temp impacts)
impact amount)
temp impacts
am
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 ❑

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
Name of Property Owner: LIA% a RA.�I-)01 Ftm, S,vva k 128u� ND�
Address of Property:
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Agent's phone #: fi 9 ? 2 3 -7,V q3
Mailing Address: I/® 4i.,c4 ?17A (<,OR
ea,v , .yG 2 8 %9 q
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 drawing with dimensions must be provided with this letter.
A�— f have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext,
Wilmington, NC, 28405-3845. 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.
WAIVER SECTION
I understand that a pier, dock, 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 initial the appropriate blank below.) RECEIVED
I do wish to waive the 15' setback requirement. DCM WILMINGTON, NC
1 do not wish to waive the 15' setback requirement. MAY 18 2017
(Property Owner Information)
U�6
Signature
uwkb�' G H
Print or Type Name
37/y wlllawccK PI?i2I< vie.
Mailing Address
(Adjacent Property Owner Information)
b`
Signature
GFAAL©
Print or Type Name
Mailing Address
r\
-L/.'/-- •- -tt.a ._i 'i ,OU AA2

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: (/fiyNt. RA.lgo&PI-/ r-o,, 5,,,,5 k, , K44
Address of Property:
Agent's Name #:
7 /1 iDg iv e 3B
(Lot or Street #, Street or Road, City & County)
Agent's phone #: 9'19 323 -7yg3
Mailing Address: 3'21`/ 14V T/o0'1C4 ?1U014 D&
_t t l *II If fo,v , 41c 2 8 Ye 9
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 drawing, with dimensions must be movided with this letter.
D
I have no objections to ibis proposal 5 I hav%objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in
ex/
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certified Mai!
WAIVER SECTION
I understand that a pier, dock, 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 initial the appropriate blank below.)
RECEIVED
iU4 1 d sh to waive the 15' setback requirement. DCM WILMINGTON, NC
I o not wish to waive the 15' setback reauiremEnt�
MAY 18 2017
(Property Owner Information) (Adjacent Property Owner Information)
l�l r .
Signature Signa ure
"Aar -J 2 A 'ZL- I LL,)' l k , A5
Print or Type Name Print or Type N me
3 2iy G�!/!/oG.c� K Pl tl die. l 9 b l u d �. ✓� i t
Mailing Address Mailing Address

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Inbox (8)
Jennifer Hall
Starred
to me
Sent Mail
Wayne Randolph has the consent of the Snug Harbor HOA to obtain permits to install a finger per to the existing dock located at the property 711 Can
Carolina Beach, INC 28428
Drafts (2)
Notes
More
.' Cock here to Reply or FOIWafd
© Wayne +
Juiie Randolph
0.3100 (2%) or to 08 utad Terms Pnvacv
Irwitation sent
Manaus

■ 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:
Jt---r(.ty w1 L11i" 5,
A
B. Rece d O(PrintedName) C
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D. Is delivery add different from item 1
If YES. enter delivery address below:
3. Service Type ❑ Noi
• Adult Signature 0 II I I IIII III) III I II II II (III I I I II IIIIIIII II I I El Adult
fiSignature
d M ®Restricted Delivery ❑ Dello
QF9n 9402 2500 6306 2289 23 ❑ Certified Mail Restricted Delivery ❑ Men
❑ Collect on Delivery
7 016 2 710 0 0 0 0 ❑collect vnaDlelirery Restricted Delivery o sign
0 6 8 9 2 2 8 3 „ail Restricted Delivery Rest
PS Form 3811, July 2015 PSN 7530-02-000-9053 Domest.
■ 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:
a `4.4 L D Si,j t H
C,k'�y , ti, c Z ?5-/1�e
A. Ignature
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B. R eived by (Printed Name) C.
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D. Is delivery address different from item 1
If YES, enter delivery address below:
11 I IIIIII I'll III I II II II i II I I I I I II Ililll III (III 3. Service Type ❑ Priors
❑ Adult Signature ❑ Regis
❑ Adult Signature Restricted Delivery ❑ Regis
9590 9402 2500 6306 2289 30 ❑ Certified Mail® Relive
❑ Certified Mall Restricted Delivery ❑ Retun
❑ Collect on Delivery Merct
2. Article Number (Transfer from service label) ❑ Collect on Delivery Restricted Delivery ❑ Signs
❑ Insured Mail ❑ Signa
7 016 2 710 0000 0688 9993 0i l Restricted Delivery Restri
PS Form u y - Domestic
RECEIVED
DCM Wil AAIAIrTnni fir+

First -Class
USPS
Permit No.
9590 9402 2500 6306 2289 23
United States • Sender: Please print your name, address, and ZIP+4®in this b
Postal Service
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USPS TRACKNG #
Postage &
USPS
Permit No.
9590 9402' 250-d "6306 2289 30
United States • Sender: Please print your name, address, and ZIP+4® in this b
Postal Service
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DECEIVED
DCM WILMINGTON, NC

DCM WILMINGTON,,NC
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DECEIVED
GCM WILMINGTON, NC
MAY 18 2017
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