56639D - Kent

Name of Property Owner:
Address of Property:
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(Lot or Street #, Street or Road, City & County)
Applicant phone#: �[%7�-�r C ,fa 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 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 objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangement.nebcontact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notfed 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
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Si ure
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Print or Type Name
Mailing Address
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City/State/Zip'
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Telephone Number
(Riparian Property Owner Information)
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Signature
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Print or Type Name
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Mailing Address
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City/State/Zip
60 - 3,i4- (qo
Telephone Number
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7-22-I
Date

Name of Property Owner:
Address of Property:
jp (Lot or Street)#, Street or Road, City & County)
Applicant phone #: �/ l � h ��`� 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 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 objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastaimangement.neticontact-dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been noted 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 t e 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.
(Property)Dwrner
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Print or Type Name
(Ripe ' n Property Owner Information)
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On-
Signature
Print or Type Name
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Mailing Address Marling Address
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City/State/Zip City/State/Zip
9/0 -S9d-999/
Telephone Number
Date
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Date

�A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
P,Pvedv Eaves Perdue. Governor James H. Gregson, Director Dee Freeman, Secretary
Date 1-),2 - I `
Name of Property Owner Applying for Permit:
Y
Mailing Address:
I certify that I have authorized (agent) -'I to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
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at (my property located at)
This certification is valid thru (date)
911 /;I

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C Division of Coastal higt, Habitat Impact Computer Sheet
plicant: POWoPermit #:
te:
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
bitat 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)
vv
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 ❑

B AND B MARINE CONSTRUCTION
1168 COREY DRIVE
WILLIAMSTON, NC 27892
DATE '
PAY J
TO THE
ORDER OF
® WACHOVIA
Wecl- via Bank, a &"o/n ooff(Wells
sFFargo BannK N.A.
FOR--
u800 L 100no 1:0 5 3000 2 191: 2000D S 44413 ?DOo'