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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
at McCrory Braxton C. Davis
3overnor Director
John E. Skvarla, III
Secretary
AGENT AUTHORIZATION FORM AGENT AUTHORIZATION Furth
Date
me of Property Owner Applying for Permit:
Barry and Karen Wishon
rner's Mailing Address:
7608 The Pointe
Raleigh, NC 27615
one Number "1_�)349-8289
6/6/17
Name of Authorized Agent for this project:
_Grice Constructio
Agent's Mailing Address:
6618 Beach Drive SW
Ocean Isle Beach, NC 28469
Phone Number [phone]
?rtify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
and obtaining all CAMA Permits necessary to install or construct the following (activity):
my property located at
s certification is valid thru (date)
\ - V W
Property Owner Signature / Dat
/) i / •/ 1/ 1 1 1
2� �� �'7 a

17/2012 02:39 9105799096 GRICE CON PAGE e
wends grice
adjacent riparian property owners notification form
C-'. July 28, 2017 at a 1a PM
DIVISION OF COASTAL MA
ADJACENT RIPARIAN PROPERTY OWNER
Name of Property Owner. Z)a(` ,,4l3 n
Address Of Property `� 11 of or Str # StreeT or Road, pity
Agent's Name ll:G\tr—k *-V5NY Mailing A
Agent's phone # �IQ 1,�� ]SA %i-AS
I hereby Certify that I own property adjacent to the above refe
has described to me as Shown on the attached drawing the d
with dFfnensma must be provided wiM ttMa l r
I ha,•e nti ,,hjrrli�,n,. to this prv�ls�l. I ha, c ab
H you have objections to what is being proposed, you must i
in writing within 10 days of receipt of this notice. Correspon
Ext., *11mington, NC, 28405.3845. DCM representatives can
is Considered the same as no objection N you have been not
WAIVER SECI
I understand that a pier, dock, mooring pilings. breakwaler, boath
distance of 15' from my area of riparian aGOeSs unless waived by
I
t appropriate blank below.)
i I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requireme
(Property Owner Information)
.\ �K nCrllll't'
Pnnt or Type Name
Allef ina AdCrsAa 000to Adl
� c-,tn� \yL. -2-
Clty/stn p cily/slswis
Telephone Number relaphone
ems' \ C - %—i
JA�7cent
GEMENT
IVER FORM
X;:�& y �� 2 %�Y
property. The individual applying for this permit
vent they are proposing. AqV§5Zigfiorl or drsriritxi.
u.. this prol%mol•
r the DNvislon of Coastal Management (DCM)
e Should be mailed to 127 Cardinal Drive
be contacted at (910) 7W721 S. No response
by Certified Mail.
lift. Or groin must be set back a minimum
(If you wish 10 waive the setback you RIB
-II; n,1./�G1,
information)
Print Type Name
1
D NC '7�

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:`'U v+-6r)
Address of Property: 10— 1 al(lcaQj�(4Ch
(Lot or Street #, Street or R6ad, City & County)
Agent's Name
Agent's phone #:q) - S-M-CWckJ
Mailing Address: t�tUl% �eCh �3W
C_ sL-4rX- Q 3 �k IYC 7—<0 y
I hereby certify that I own property adjacent to the above referenced property. The individual applying for
this ermit has described to me as shown on the attached drawing the development they are proposing.
I 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 Di VI ' p of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Corres a should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM represen� can also be
contacted at [phone]. No response Is considered the same as no objection llyk'Sbeen
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
set4 ou must Initial the appropriate blank below.)
.1
1 do wish to waive the 15' setback requirement.
IZ
I do not wish to waive the 15' setback requirement.
(Property Own r formation)
Signature
Print or TypeWarne
Mailing Address
\L 2
City/State
NO --:;uC1 R-RCI
(Adjacent Property/-Pwner Information)
Signature /119
1 l
Print or Type Name
Mailing Address
n
city/stateaO

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: i6a`�,' , 016r1
Address of Property: 1_.�'Na `- Vh a6 � '0— i cciy- �(461
(Lot or Street #, Street or R ad, City & County)
Agent's Name
Agent's phone
� h
Mailing Address: � ��is C �
Ct�)C 2�, L uQc ,
T
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.
I 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. Corresponrrce should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC, 28405-3845. DCM representeMvps can also be
contacted at [phone]. No response is considered the same as no objection tf yoo hire 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 piust 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 Own r nformation)
Signature
r�u �4�U n
Print or Type Name
f� I o\k 1
Mailing Address
l
City/State
C�\(c BUG
;(Adjacent Property Owner Information)
Signature
Print or Type Name
y D 9 l—)y✓4tiCc `j, rx—
Mailing Address
' I�J,. 4— tic
City/State2rp
e�t4—- --)G,ti

■ 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:
Dwv lkc�Ar-
'Of--
e��� NC 2-API5 -` 63a
A. Signature
X ❑Agent
❑ Addressee
B. Received � rinted Name) I C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, en _ elivery address below: ❑ No
OFFICE
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For delivery information, visit our website at www.usps.corno.
In
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