63959D - H & H

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DENR CAMA Dailv Check Loci for WIRO
Date Received I Check From (Name
6/18/2014 Grice Construction of Brunswick County
6/19/2014 Hammocks at Shallotte Pointe LLC
6/20/2014 Vil laver Law Firm
6/23/2014 Bank of A Money Order
6/23/2014 Carolina Marine Construction, Inc_
6/23/2014 Reggie W. Barnes Jr
6124/2014 'Charles F. Riggs & Associates Inc.
6/24/2014 Richard L. and Erica J. Penny
6/25/2014 Clements Marine Construction Inc
6/25/2014 Snow Marine Construction & Dredging, Inc
6/25/2014 Elite Homes By Forrest Taylor, Inc.
- -- -
6/25/2014 Grice Construction of Brunswick Coin __
Holder
T
Steven Villaver
Brandon Grimes
Brandon Grimes
Cord Grass Bay HOA
Giles Jeffreys & Lee Thornton
Jason Dixon & Lee Thornton_
Mike Turbeville & Greg Coiner
Dan Smith
Charles Ashley Mann
Cableu, LLC
H & H Construction
H & H Construction
Check Number I Check amount I Permit NumbedComm
9702
1053
$200.00
$100.001
J GP 63266D
modification of MP #93-08
5992
$200.00 GP 63202D
1139200122
$497.00 Vio# 14-03D B & B Marine
+ GP 63955D ($47)
1139200122
9105
_
$400.00 GP 63957D
$100.00 Transfer fee #70-09
$600.00 GP 63952D @$200
j G P 63954D @$200
GP 63953D $200
1200
13510
535
$200.00
GP 63924D
3488
$650.00
GP 63962D @$400
_
Major fee Smith $250
2839
$250.00
Ma'or fee Mann NHCo
8046
$200.00
GP 63973D
9710
$400.00
GP 63958D 0$200

NC Division of Coastal Mgt, Habitat Impact Computer Sheet
Applicant: �, C`h �� Permit
Date. -
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measureme
found in your Habitat code sheet.
Habitat 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 fii
disturbance.
Excludes any
restoration an(
temp impact
amount)
Dredge ❑ Fill ❑ Both ❑ Other
LZ
Dredge ❑ Fill ❑ Both ❑ Other
�Z
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 E] Other ❑
Dredge ❑ Fill ❑ Both 1711 Other ❑

AW Y/1\
ASV `_
MCA a C,Ic
North Carolina Department of Hnvironment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. ftAz John E. Skvarla, III
Governor Director Secrelmy
AGEN"f AUTHORIZATION FORM AGENT AUTHORIZATION 1=UI-<M
r
Date: I '
Name of Property Owner Applying for Permit:
it r r
Owner's Meiling Address:
Name of Authorized Agent for this project:
Agent's Meiling Address:
Phone Number Wit, , ? ',' Phone Number "f i ! c)
1 certify that I have authorized the agent listed above to act o►) my behalf, for thb purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
cA_ 1 1 I c l
For my property located at : (.
This certification is valid thru (date)
Property Owner S gnaturo Date

CERTIFIED MAIL - RETURN RI CI PT REQUEbTE'D
DIVISION Off COASTAL MANAGPMENT
ADJACENTHINARIAN PROPERTY OWNLIT NOTIFICATIONfWAIVER FORM
Name of Property Owner:
r
Address of Property: �• i ., {�` �,L _ ; , i _
(Lot or Street It, Street or Road, City & County)
Agent's Name It:( _ �, ; t. Mailing Address:
Agent's phone #: ' i j
I hereby certify that I own property adjacent to the above referenced properly. 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 objectiorns to what is being proposed, you must notify the Division of Coastal
Management (DCM) in writing within 10 days of recelpt of this notice. Corresporndenco should be
malleci to 127 Cardinal Drive Ext., Wilmington, NC, 28405.3845. DCM representatives can also be
contacted at [phone]. No response is consiclerecl the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
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.)
I do wish to waive the 15' setback requirement.
do not wish to waive the 15' setback requirement.
(Prq{�rQl Owner In fo •r �lon)
.Signature
Print or Type Name
t(55
Mailing Address
Cil y/SlatelZip
1` (Adjacent Property Owner Information)
Print or Type Name
Mailing Aciclress
lLiy( )
City/Statelzip

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER DORM
Name of Properly Owner: I ! t I i`�:i��; t : ► t i
Address of Property: I c: t `► (i ` I i�;r;� l l� '> I�r ' f), . .`,, . ;•: > > fc l i ,r1'c )',(I l: `� "
(Lot or Street ll, Street or Road, City & Counly)
Agent's Name ll: (.,,, , (`� -� ,; I : l (1:::. • . "I Mailing Address: �, r '�:
Agent's phone fl:
I hereby certify that I own properly adjacent to the above referenced property. The individual applying for
this permi�ias described to me as shown on the attached drawing_Ihe development they are proposing.
I have no objections to this proposal. I have objections to This proposal.
If you Dave objections to wltat is being Proposed, you must notify the Division of Coastal
Management (DCM) In writing within 10 days of receipt of this not/co. Correspondence should be
malled to 127 Cardinal Drive Ext., Wilmington, NC, 28405.3846. DCM representatives can also be
contacted at [phone]. No response Is considered the same as no objection if you have beer)
notified by Certified Mall.
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 1 setback requirement.
PrOwner h�)fo t � talon)
Signature V "V
Print or Type Name
Mailing Address
t-<,.yr'f((-,k;',11
Cil y/State2ip
djac nt Proporty Owner Information)
�b
Sigunlure
Print or Type Name
;r „'.
Mailing Address
AA
Cily/State2ip
lit) •1' (-' •l )rl 'I

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