57442D - Aldridge

UtNK LAMA Ually t.;neCK Log Tor WIKV
Date
Check
Check
Received
Check From (Name)
Name of Permit Holder
Vendor
Number
amount
Permit Number/(
3/2/2015 Pacula Builders LLC
Roy Gilbert & Brenda Madison
First Citizens Bank
1138
$600.00 GP 65079D
3/2/2015 Pacula Builders LLC
Dennis Michael
Security Savings Bank
1847
$400.00 GP 65102D @$2C
Dennis Michael
GP 65103D @$2C
3/2/2015 David Lee Builders, Inc
Edwards
B of A
19918
$100.00 minor fee, TB 15-C
3/3/2015 Carolina Marine Construction, Inc.
John Clark
First Bank
9496
$400.00 GP 65093D
3/3/2015 East Coast Engineering & Surveying, P C.
Dinah Gore
First Bank
1308
$100.00 minor fee, SB 15-(
3/4/2015 Hunter Development Corp.
John Ledoux
Yadkin Bank
22714
$200.00 GP 65037D
3/5/2015 Coastal Marine Piers Bulkheads LLC
James Harren
Wells Fargo Bank
20059
$100.00 renewal fee, MP 1
3/5/2015 Mark D Kelly
same
PNC Bank
795
$200.00 GP 65121D
3/6/2015 Lighthouse Marine Construction Inc
Rick Rouse
B of A
5269
$600.00 GP 65035D
3/6/2015 Bruce Marek, P.E.
Timber Creek HOA
Wells Fargo Bank
1433
$400.00 major fee, Timber
3/6/2015 Kenneth W. and Be T. Futch
same
Alliance Credit Union
10240
$250.00 major fee
3/6/2015 Gregory A Holden
same
CresCom Bank
2017
$25.00 return ck fee, 613,
3/6/2015 Gregory A Holden
Kathryn Bradley
CresCom Bank
2016
$400.00 GP 65109D @$2C
Lockwood Folly, POA replacement for rtned check
GP 65056D @$2C
3/9/2015 Garry D. Aldridge
same
NC State Employees' Credit Union
1044
$200.00 GP 57442D
I

4C Division of Coastal Mgt. Habitat impact Computer Sheet
\pplicant: eyr y ,q (41 of l o(o Permit HqZ_
)ate: iYb/,
)escribe below the HABITAT disturbances for the application. All values should match the name, and units of measureme
Dund in your Habitat code sheet.
labitat 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 fi
disturbance.
Excludes any
restoration an
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
Y �?
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 ❑
0'
L
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both 0 Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION[WAIVER FORM
Name of Property Owner:
Address of Property: wt— Ad4co" I/I e .ZB��,
(Lot or Street #, Street or Road, City & County)
Agent's Name #:
Agent's phone #:
Mailing Address:
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.
,//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. Contact information for DCM offices is
available at http://www.nccoastalmanaaement.netlweb/cm/staff-listing or by calling 1-888-4RCOAST.
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, boat ramp, breakwater, boathouse, or lift 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Print or Type Name
(Riparian Property Owner Information)
Sig ture
Print 6r Type Name
Mailing Address
Mailing Address

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION[WAIVER FORM
Name of Property Own
Address of Property:
Agent's Name #:
Agent's phone #:
Mailing Address:
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.
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. Contact information for DCM offices is
available at http://www.nccoastaimana_qement.netlweb/cm/staff-listinq or by calling 1-888-4RCOAST.
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, boat ramp, breakwater, boathouse, or lift 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Inform tion)
Signature
Print or Type Name
f- o. t-f- P �
Mailing Address
(Riparian Property Owner Information)
Signature
T e's latr f"lam
Print or Typ Name
Mailing Address ,,

i
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