63958D - H & H

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DENR CAMA Dailv Check Loa for WIRO
Date Received I Check From Name Name of Permit Holder Check Number Check amount I Permit Number/Comme
- 6/18/2014 Grice Construction of Brunswick County John Teague 9702 $200.00 GP 63266D
- ---- —
6/19/2014 Hammocks at Shallotte Pointe LLC 1053 $100.00 modification of MP #93-08
6/20/2014 Villaver Law Firm Steven Villaver 5992 $200.00 GP 63202D
6/23/2014 Bank of A Money Order Brandon Grimes _ 1139200122 $497.00 Vio# 14 03D B & B Marine
Brandon Grimes 1139200122 _ + GP 63955D $47 _
6/23/2014 Carolina Marine Construction, Inc Cord Grass Bay HOA _ _ 9105 $400.00 GP 63957D
6/23/2014 Reggie W_Barnes Jr 1200 $100.00 Transfer fee #70-09 _
6/24/2014 Charles F. Riggs & Associates Inc. Giles Jeffrey & Lee Thornton 13510 $600.00 GP 63952D @$200
Jason Dixon & Lee Thornton GP 63954D @$200
- - 9- - 3535 $200.00 ---
Mike Turbeville & Greg Colner _ __ GP 63953D @$200
_ 6/24/2014 Richard L. and Erica J. Penny _ _t 535 $200.00 GP 63924D _
6/25/2014 Clements Marine Construction Inc �an Smith GP R39R9n rni Rann
14 Snow Marine Construction & Dredging, Inc Charles Ashley Mann 2839
6/25/2014 Elite Homes By Forrest Taylor, Inc. Cableu, LLC 8046
6/25/2014 Grice Construction of Brunswick County H & H Construction g7jp
__ -- _ _ _
H & H Construction
Major fee LE
00 Major fee I
00 1 GIP 63973D
00 GP 63-958D
GP 63959D

C Division of Coastal Mgt, Habitat impact Computer Sheet
` Permit #: �3 �SgD
iplicant: �i vV CGL'4fftha--)
i
ite:
ascribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
abitat Name
DISTURB TYPE
Choose One
Dredge ❑ Fill ❑ Both ❑ Other
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 fina
disturbance.
Excludes any
restoration andh
temp impact
amount)
Dredge ❑ Fill ❑ Both [IOther
1
f
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 El Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

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North Carolina Department of Environment and Natural Resources
a)Wision of Coastal Management
Pat McCrory Braxton C. Davis John E. Sbarla, III
Governor Director Swmary
AGENT AUTHORIZATION FORM AGENT AUTHORIZATION FUHM
Date: � /t :; it l
Name of Property Owner Applying for Permit:
I! ! (1 (! t J (
Owner's Mailing Address:
��.3A
Phone Number
Name of Authorized Agent for this project:
Agent's A+lelling Address:
IN
Phone Number cf ,1&', k • f:_� _r;
I certify that I have authorized the agent listed above to act on my behalf, for the purpos* of applying
for and obtaining all CAMA Perivift necessary to install or constrrwA the Wowing (activity):
le. 1 I. �_ll ,, (•1 �( t %c.�'•�(, t :� �� l! r I (' .'�- l �, %,.
' t
t ` 0,1; C
f-or my property locatod at ` t.'l- 1.0
^I
This certification is valid thru (dale)
Property Owner Signature Date

GFRTIFmi) MAIL • RETURN RI?CFIP T REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Properly Owner: ! I
Address of Property: I It,,, c � ; ;,. � 1, � �, ,� ( i is I : ; /. (
(Lot or Street it, Street or Road, City & County)
Agent's Name tl: l ! �. Mailing P�Idress: i �,_� ^h ,1;
Agent's phone #:
1 hereby certify that I own properly 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 (his proposal.
If you have objections to what is holm proposed, you must t)otify the Divisfa►r of Coastal
Management (DCM) in writing wlthln 10 days of receipt of this notice, Correspondence should be
malled to 127 Cardinal Drivo Ext., 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
notifled by Cerlified Mall,
WAIVER SECTION
understand that a pier, clock, mooring pilings, breakwater, boathouse, lift, or groin nutst 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.
{Proparjy Owner Informatiq'1)
Signature �I
Print or Type Name
Mailing Address
- (Adja lit Property Owner 11 fort ration)
Signntru•e
Print or Type Name
_ ; _ .5 r r�•1 � 1. ; n. 1/f�: •J ', ►/�: /.)c"i
Mailing Address
City/Stale2ip
City/State2ip

CERTIFIED MAD.. — RETURN RI CEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENTRIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: ' ►.1 (`. ', , ,, I :�.', .
Address of Properly: (,`, 1c::J ; ICI I 11.E ' ", t ., r: Q, 1, Nr!(
(Lo(or Street ll, Street or Road, City & County)
Agent's Nameti:C1; i r'-:' (`.c:•�-;;::.:,1, , ( }::•, ;..; I .Mailing Address:
Agent's phone it: Lill %'►Vr
I hereby certify 1.1 t I own properly adjacent to the above referenced properly. The individual applying for
this permit hasldescribed to me as shown on the attached drawing the development they are proposing.
I have no objections to this proposal. I hive objcctions to this proposal,
If you have objectlons to what Is holm proposed, you must notify the Dlvlslon of Coastal
Management (DCM) In wrlthrg within 10 days of r•ecelpt of tits notice. Correspondenco should be
mailed to 127 Cardlnal Drive Cxt., Wilmington, NC, 28405-3845. DCM reprosentatives can also be
contacted at [phone]. No responso is considered Hie same as no objectlon if you have been
notifled 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 Initlal the appropriate blank below.)
I (to wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pror Owner h fo • �(loii) Jaunt Pr pq -1 vv rer Information)
r(�Signature Signature
Print or Type Name
Mailing Address
Print or Type Name
Mailing Address
City/Stale2ip
<-I 10- ii
City/Stale2ip '
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