57358D - Boyette

CAMA / DREDGE & FILL
E N E RAL PERMIT Previous permit #
New' . -:Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
prized by the State of North Carolina, Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC H , Loop
attached.
itNaame : ' Project Location: County Q t d iZles
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Street Address/ State Road/ Lot #(s)
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zed Agent
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MOMMEMOMMEMEMOMME
ling permit maybe required by: N e W td m1 yc✓ ❑ See note on back regarding River Basin

j 17 A� 1 n
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: fio))C t 1 o wir we
Address of Property: 17 Sar1 eu roi nt t1,)i 1 m L nQ �cr)� Me j-) F6n oycj—
(Lot or ttreet #, Street or Road, C4ty & County)
Applicant 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 arey. A description or drawing, with dimensions, must be provided with this letter.
objections to this proposal. I have objections to this proposal.
NO h?yj0Uiections to what is being proposed, you must notify the Division of Coastal Management
(D riting within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangement.neticontact-dcm.htm 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, 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.
N/A I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Sigrtul ure
}& bfft �Ro a e
Print or Type Name
g(oDI �+i ccnthc Avc
Mailing Address
,A , I 1 ^ - - . -
. ,
rian Property Owner Information)
Print or Type Name
1'5 Stu ?oint
Mailing Address

:BLUE GEM FAX NO. :336 230 1360 Jun. 03 2011 10:06AM P1
UN-3-2011 08:E0A FP00!:0VMELm0',—F PPTN YAP.X iSirJ)6E5 :ZEE U:za�����s�
CERTIF ICD MAIL • 9TURH RIEcEIRT REQgCSTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FOI"tf+iil
Name of Property Owner-
.. . - ..: ��.Iill`ti!•J�riil�ft 6�1=�11�l���will
Applicant phone*,.
Mailing Address:
that I own property adjacent to the above referenced property, The individual
Vvft6kas described to me as shown on the attached drawing the developrne;nt
1 have no ob" ctions t its propcsasl. 1 havo objections to this propoW.
ff you have to prOposed, you MuOisoW the Urrslan Of COWN1 Afarte9e 011
it9 w' ys of ruceipt of this notice. Cvstact krformatfon for ©CU offrces is
uaratfabie stt�fman gerrrerrt.rw t*ntW dcm.h&n cr by tefiingr i-8884RCOAST. No
rdet8ef t;* same as no obtottlon if you have boeis sot1 W by G8rt %d U&M. ---
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a
minimurn distance of 15`;arn my area of riparian access unless waived by me (If ym wish to
waive the setback, you must. initiai arse appropriate blank below.}
0% I do wish to waive the 'IS' setback reorement-
n n I do not wish to waive the 15'
(Property Owner Intormation)
Signature
print or Type Name
Mew Address
CR>6'taW -
Kgn=re
R,a
Muifi N Address
7'etephone Number
Te*phona Number 42M 2 -3o'al -x ,138o

; Division of CDastal &19t° Habitat impact Computer Sheet
licant:
cribe below the HABITAT disturbances for the application
id in your Habitat code sheet.
Permit #.
All values should match the name, and units of measurement
TOTAL Sq. Ft. I
(Applied for. (.
DISTURB
TYPE
Disturbance total
,itat Name
Choose One
includes any
anticipated
restoration or
temp impacts)
)�
Dredge ❑
Fill ❑
Both ❑
Other
1
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 ❑
Other ❑
=1NAL Sq. Ft.
TOTAL Feet
FINAL Feet
Anticipated final
(Applied for.
(Anticipated final
disturbance.
Disturbance
disturbance.
Excludes any
total includes
any anticipated
Excludes any
restoration and/or
restoration
and/or temp
restoration or
temp impact

Tr
OVERBECK/PIPPIN MARINE CONTRACTORS, LLC
X 716
WRIGHTSVILLLE BEACH, NC 28480
PAY
TO THE
ORDER OF
MEMO ,
1110040 3 ?11■
MCIMSCEW
STATE B4 VK
Wilmington, NC
66-1227-531
c-
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AUTHORIZED SIGNATURE
Gu53112275q 0002SO?21, 2115