57577D - Giles

nlicant: G1 L1�S/ O L
te: 101-7/11
Permit #: b 7 S 7l7
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measuremer
nd in your Habitat code sheet.
TOTAL Sq. Ft.
(Applied for.
DISTURB TYPE Disturbance total
)itat Name Choose One 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 fin
disturbance.
Excludes any
restoration and,
temp impact
amount)
`
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

-AML American Fish Company
n ' P.0 Box 11046
Southport. North Carolina 28461
Email AFC03600®aol com
AZc,\,j \,,]
iNvOK ENO M
e
[phone]
[phone] F
3i

'a+5 76 �51
Name of Individual Applying For Permit: TOP_ � "its
Address of Property
"Lot or Street #, Street or Road)
(City and County)
Au.
u7 4
hereby certify that I own property adjacent to the above. referencto proper-y. The inditi
applying for this permit has described to me us shown on the aneched drawing the developmen
are pronosing. A description or drawing, with dimensions, should be crovided with this 1et4
JX r have no objections to this ro osai
P P
i1' You have objections to what is being proposod, pie -Ise write the Di" isic (I of
Co
,�%[129emcnt, 127 Cardinal Drava Extension, Wilmington, INN 28405 or rail 91 •796.
wirbio 10 days of receipt of thls notice, No responso is considered the same as no object,
you hsve been notified by Certified Mail,
WAIVER SECTION
i understand that a pier, dock, mooring pilings, bronkwater, boat house or boat iift mustb
ock a minimum distance of ls' from my Area of riparian access. unless waived b� me. (I'
isn to Woil-'e the setback, you must initial tho appropriate blank below.
' do wish to waive the 1 setbackv4D&
reat:ire,�e�:
t do hoc'tsh to Nvaiyc the
J

ftY
► I�w�► o�
NGENK
North Carolina Department of Environrlient ana Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director ^liifa
Authorized Agent Consent Agreement
0� r— P'u" r is hereby autheriz_c
(Printed Name bf Agent)
in order to obtain any CAMA permit(s) required for the property listed below. The authorizaticn Is rr..
specific activities described in the attached sketch.
LOCATION OF PROJECT:
Qok -�l 7-V4.` 5�
PROPERTY OWNER MAILING ADDRESS:
`310 \,&1c5+ vkvi a s-'
P.o, 1DMI),nc Al-3s
PHONE NO. OttO -811 - 27 21
AUTHORIZED AGENT MAILING ADDRESS:
3 6 O 'o 0 l O pic t o(ot r D
5Pt A. C. 21rao
PHONE NO.
Sicrrature of Property Owner:

1 0 : 'a45 7 6;51
Name of Individual Applying For permit; _�OP1 IeS
Address of Properrr.
(Lot or Street > , Street or Road)
(City and County)
Ar<
hereby certify that I own property adjacent to the above referenced grope.-y. The indii
applying for this permit has described to me as shown on the attached drawing the 6velopmer
are prorosing. A description or drawing, with dimensions, should be crovided with this letl
r have no objections to this proposal,
Vou have objections to what is being proposod, please write the DiN, isif r) of Cc
1.laoagement, 127 Cardin.tl Drivo Extension, Wilmington, NC 284O5 or c:111 91' 496.
within 10 days of reccip.t of this notice, No responso is considered tl�e same as no object
You have been notified by Certified Mail,
WAIVER SECTION
I understand that a pier, dock., rn.00ring pilings, bronkwater, bout house Or boat lift must t
Eck a minimum distance or13' from my area of riparian access . unless NvQived b'% rne, (I
" iso to N+'aive the setback, you must initial tho appropriate blank belo��—'
do wish to waive the 1 setback reouir ;„a1.
not' ish to Nvlive the 1 setback rcQ siren :n:
D a L c/,-
arinr Nr.me �[ =�A

0

THE AMERICAN FISH CO.
CHARLES H. OR KAREN Z. PERRY
P.O. BOX 11046
SOUTHPORT, NC 28461
rst Citizens
ink ryy
'c, i»en�s�n,
110013 36 5 Lu' 1:0 5 3 L00 3004004 5 3
83651
DATE _ 11- l 6-I( 66-30/531
$ ;2©®•oo
DOLLARS