64740D - Crumbley

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8/24/15
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Rick West for West Docks - William- MauneyFirst
Bill and Ann Crumbley
Bank 101 $600.00IGP 64739U (a3$4t
GP 64740D @$2(
First Citizens Bank 5436 $100.00 renewal fee, MP 3
Wells Fargo 393 $400.00 major fee, 1 mile c
-
NC State Employees Credit Unior 1428 $200 00 GP 64786D
First Citizens Bank 11651 $100.00 major mod , P 28
BB &T 11651 $100.00 renewal fee, PM 1
BB &T 5294 $100.00 minor fee, 209 Ca
- --
First Citizens Bank - 1523 $100.00 renewal fee, MP 1
First Citizens Bank 1522 $100.00 renewal fee, MP 1
Wells Fargo 3483 $200.00 GP 64795D _
US Trust 7167' $250.00 major fee, 44 Peii
First Citizens Bank 1521 $100.00 mod fee, MP 172•
B of A 34483 $200.00 GP 1161 Spot La
Four Oaks Bank & Trust 1283 $200.00 GP 64761 D
B of A 1069 $200,00 GP for Lot 20, Th
North State Bank 1721 $100.00 mod fee, MP 84-(
NewBridge Bank 6197 $200.00 GP for 1244 Rive
r
8/21/2015
8/24/2015
8/24/2015
8/24l15
8/24/15
8/24/15
NC Baptist Assembly John Aldridge for NC Baptist Assembly
Johnnie S Hawkins Jr Specialty River Woods Go Steven Woodcock
— — ---
John King Butch Saunders
North Carolina Coastal Federation same
Christopher Luttedoah Sr same
-- -
Donald and Joanna Reich same
Bald Head Island Limited LLC Bruce Marek, representative
Bald Head Island Limited LLC Bruce Marek, representative
Pippin Marine Construction LLC Chris Hughes __
Edwin or Sandra Bartlett same
Bald Head Island Limited LLC Bruce Marek, representative
Lanier Family Limited Partnership Donna Lanier
LLBBD, LLC David Jones
Connaway Marine Construction ?
Waterfronte ...as Owners Association same
Joseph and Lara Milligan ?
Paul J. Schadt same
Allied Marine Contractors LLC Rick Woodard
8/24/2015
8/24l2015
8/24/2015
8/24/2015
8/24/2015
8/25/2015
8I25/2015
8/25/2015
8/25/2015
8/27/2015
8/28/2015
BB &T
4982
$100.00
minor fee, 840 Cs
8/28/2015
B of
7756
$600.00
GP 64799D @$2
GP ? @$400
8/28/2015
Joan Lee

NBC Division of Coastal M9ty Habitat Impact GOMPuter Sheet
�� b Permit #:
applicant: 41 � C�v
date: � f
describe below the HABITAT disturbances for the application. All values should match the name., and units of measurement
`ound in your Habitat code sheet.
iabitat 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)
Dredge ❑ Fill ❑ Both ❑ Other
I ��
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 0 Other ❑

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date Y —/ 0
Name of Property Owner Applying/ for Permit:
L L e- C f b 4 /r-v
Mailing Address:
U 7 N e r i- ck, c6 2-ri�
I -Si 014 u I' 14 jr- I . c:;�, (?6 6- /
I certify that I have authorized (agent)
Ves,S
to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) �% e (,L) �0 e- l< / ti S,
at (my property located at)
This certification is valid thru (date)
// — J/- /s,
I Property Owner

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
11 I hereby certify that I own property adjacent to '— . � L C2 �� 's
(Name of Property Own )
property located at / �J IF< < �� _�rcG
(Address, Lot, Block Road, etc.) C7
on , in (�, i a /lJ (­1 N.C.
(Waterbody) (City/Town and/or County)
( The applica -'has described to me, as shown below, the development proposed at the above
location.
1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(IndividuAf proposing development must fill in description below or attach a site drawing)
me. (If you
I do
I do
7
Sys -J(f tm
/ LL Lac;
kI �� 0.),
WAIVER SECTION
a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
a minimum distance of 15' from my area of riparian access unless waived by
rwaive the setback, you must initial the appropriate blank below.)
to waive the 15' setback requirement.
to waive the 15' setback requirement.
i Prootyr. 0 r Information)
Signature
(Adjacent Property Owner Information)
Signature*
Print or Tyne Name
Print or Type Name

iplete items 1, 2, Ana 3. I
t your name and address on the reverse
hat we can return the card to you.
ich this card to the back of the mailpl e,
>n the front if space permits.
:le Addressed to:
LA
❑ AOUR V91I — C Reg's1w—
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0024 5071 2353 o Colllect o Del; Delivery ❑ Signature Confirmation
ransfer from service label)
Restricted Delivery
alicle Number T __ ul Reawtod d^li:pv
— -.
7 015 0640 0005 2 815 2 3 Domestic Return Receipt
Form 3811, April 2015 PSN 7530 02 000 905
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t your name and address on the reverse
hat we can return the card to you.
'h this card to the back of the rnailpieCe
t the font if space permits.
'- Addressed to:
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Service Type
3; Adult
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. April 2015 PSN 7 530-02-000-9053
Restricted Delivcyy
Signature Confirmation
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Domestic Return Receipt
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(18/11/2015
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Postmark
Here
08/11/200
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