56642D - Honeycutt

ADJACENIT RIPARIAN PROPER T v OWNER \OTTICATIO?NIWAIV ER FORM
The purpose of this forrn is to provide proper notice to you as an adjacent riparian property owner to the individual or
individuals listed below. The CAA General Permit application procedures require that applicants provide the Division of
Coastal ManaQemenr confirmation That a written statement has been obtained si-•ned by the adjacenr riparian properly ownei
indicating that thev have no objection to the proposed work or that the adjacent riparian property owners have been notified
by cerriiied mail of the proposed work. Often these forms are submitted to the adjacent riparian propeM, owners by a marin
contractor or other individuals acrina as an authorized went on behalf of the applicant.
This forma was sent to you by the following individual or company designated by the applicant as an
authorized agent:
Authorized :h's Signaturt
Date
\acne of individual Appivi;ig For PermiE:
Address of PropC_riy: 30zi— 3,tP _J7--
r"Lot or Street -E. Streer or Road)
iCirt' and County;
:by cerrify that i own property adjacent to the above -referenced property. The individual applying for this perrr
escribed to me as shown on the attached drawing une deveiopment :hey are proposing. A description or drawin;
dimensions. should be provided with this letter.
a. I have no objections to this proposal.
have objections to what is being proposed. please write the Division of Coastal Management, 12
al Drive Extension, Wilmington, N C 28405 or call 91(}-%96-7215 within 10 days of receipt of this notic
ionse is considered the same as no objection if you hahre been notified by Certified MaiL
WAIVER SEC TIO.N
I anderstand that a pier, dock, mooring pilings, breakwater, boat house or beat lift roust be set back
rttlr : m distance of 15' fro.n my area of riparian access - unless waived by me. -(if you wish to waive tb
sia�k, you roust initial the appropriate biank below.)
I do wish to waive The 't 5' setback requirement.
i do riot wish to waive setback requirement.NR
Date HCDE t
L4VIRC7+MCY.' hNC NS:R.I'. C�

--,- I «,r--.f\.ih1 r W f ) ' t K I CVv`ivER It10T7FICATTOtv/�rVAVER FORM
The purpose or this forth is to provide proper notice to you as an adjacent riparian property owner to the individual or
individuals listed below. The CAMA General Permit application procedures require that applicants provide the Division of
Coasral _vianaeement confrnnation that a written statement has been obtained signed by the adjacent riparian property owner
indicating that they have no objection to the proposed work a that the adjacent riparian property owners have been notified
by certified mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by a maaring
contractor or other individuals actina as an authorized aaenr on behalf of illie applicant.
This form was seat to you by the following individual or company designated by the applicant as an
authorized a'en*: f
Au%hoij U`igerit"s SEEnanure
;,acne of Individual Applyina For Perinic �1,1014y C,/%--
Address of Properrr:
'Lot or Street. Street or Road)
f,,ti — O "-,J
i.Cin and County)
t hz eb} ce �ii=✓ that I own propery adjacent to the above -referenced propem%. The individual applying for this perm
described to me as shown on the artached drawinG the de. eiopment they are proposinG.:,_ description or dra�vin!
CPS
i dimensions. should e provided with this letter.
1 have no objections to this proposal.
au have objections to what :is being proposed, please write the Divisions of Coastal Management, 12
Y
iraal Drive Extension. Vv'ii iii?gton, ' C 28405 or call 91G-%9d- 721-4 within Ili days of receipt of this rratic
€t�Card
:response is considered the same as no objection if you have been notified by Certified Mail.
WA.xv-ER. SECTION
I itx derstand that a pier, dock, mooring pwiags, breakwater, boat house or boat lift must he set back
r€►ir i€rittin distance of Ij' from gray area of riparian access - unless waived by me. (If you, wish to waive t1
sett-.ae-k, you must initial the appropriate blank below.)
I do wish to ?wive the i 5 setback requirement.
i i do not sh to�waive fhL I setback requirement. 4
NCDENR
J. -.
di
ra'
G V1R^,t[lS�Y f1+D NGl'fi.U..�1.E-�1.4CPS

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Purdue, Governor James H. Gregson, Director Dee Freeman, Secretary
AGENT AUTHORIZATION FORM
Date
Name
©of Property Owner Applying for Permit:
Mailing Address:
I certify that I have authorized (agent) O //- ' yam,,.. to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at) J roI j— is- c .
This certification is valid thru (date)

Jim
-him
U UIL
— a �IIIINI

Division of Coastal Nigt. Habitat Impact Computer Sleet
)licant. /j l w �.�. Permit #. qP 5�vf
.e: ') j � / 1
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd 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 final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
16
Dredge ❑ Fill (Both ❑ Other ❑
2?-.10
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54
Dredge ❑ FFIX Both ❑ Other ❑
I .l
I
I
Dredge ❑ Fillps Both ElOther ❑
-ZG—LJ
2Z�
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 ❑
II=

PILINGS AND MORE v
JOHN CASSIDY 6O2H
PH: [phone]
169 LAKE HAVEN DRIVE
SNEADS FERRY, NC 28460 / r/�/�fry 66-3M31
457
PAY/Ito the i Dale
order o N RCN $
Dollars
®First Citizens
Bank-{pYIQ W
firstcitizens.comFor 1,-7 i;j1` C,/',yli*,A? �� 3i
':0 5 3 100 3001:00 4 5 7 13 2 70 L 3 0 60 28