63211D - Darsie

27/2014 08:21 9107549345 MILLIGANS DOCKS PAGE 0
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JOSEPH V. MILLIGAN
LARA R. MILLIGAN
NCDL4�19111 4299734
P.O. BQX 1�1, HWY. 130 PH. 754-9345
ASH, NC .28420
PAY
T E ER OF
5hallotte, N(/C-y]299�{459 4— .("`
MElO t)N1 N `� Dr
1: 2 CA i 7 I L :in,-- n c. annn
66-7143/2531 5974
DATE -1
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3110 c071

Division of Coastal Mgt. Habitat Impact Computer Sheet
Dlicant: 0MC1v-a-ermit #: �3Z!
ie:
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremerr
ind in your Habitat code sheet.
:)itat 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 fine
disturbance.
Excludes any
restoration and/
temp impact
amount
Dredge ❑ Fill oth ❑ Other ❑
��
S
Dredge ❑ Fill oth ❑ 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 ❑ Other ❑

AFA
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue Braxton C. Davis
Governor Director
Dee Freem�
Secrete
AGENT AUTHORIZATION FORM
Date: — I "—
Name of Property Owner Applying for Permit: Name of Authorized Agent for this project:
Owner's Matting Address:
Ladd �k
t �
Phone Number(y/91
Agent's Mailing Address:
certify that 1 have authorized the agent listed above to act on my behalf, for the purpose of applying
br and obtaining all CAMA Permits necessary to install or construct the following (activity):
=or my property located at
phis pert' ion is alid thru (date)
IP rty ig ture Date
Y4

he-d �-
CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEti1ENT
Name of Property Owner: 4�
Address of Property: J (��_� ► l�-
Lot or Street # Street Road, City &County)
AAP-
licant's hone #. .-��y--? Mailing Address: \ \l l___
PP—��
P �-l�= 4 r`
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this pe
has described to me jas shown on the attached drawing the development they are proposing. A description of drag
with dime=1have
e provided with this letter.
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 OX
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response i
considered the same as no ob'ection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a minimum distan'
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' set back requirement.
I do not wish to waive the 15' set back requirement.
(Prope wner Information)
Signature �r `lam
Print or Type Name V
_ 012 boyv\o�
NAi ;I-n Arlrlrvcc n
arian Property Owner formation)
Signat re
lC
Print or Type Name
Mailing Address

4-b sca�,
p W = Z

CERTIFIED MAIL — RETURI RECEIPT RE QUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Name of Property Owner:
Address of Property:
1(C�[—N04A-10re.. 3
(Lot or Street #, Street or Road, City & County)
Applicant's phone #: - ` l 6D Mailing ress: Add_
—. ---- - o
OR
\`
I hereby certify that I own property adjacent to the above referenced property. The individual applying for this pej
has described to me as shown on the attached drawing the development they are proposing. A description of draw
wi
th 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 (DC]
in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive ]
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, or lift must be set back a minimum distance
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.)
t� I do wish to waive the 15' set back requirement.
I do not wish to waive the 15' set back requirement.
(Property Ow r I orm ion)
Signature
kilt
Print or Type NameW� 131,rcA ''�
MAino Arlrlrecc
Property
kesl Ali
Print or Type Name
Mailing Address , ,

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