57514D - Mitchell

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C. M. Mitchell Construction Co., Inc.
P. 0. Box 409, Sneads Ferry, NC 28460
Phone: [phone] Fax: [phone] �
fax
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FROM: Jerry Costars
FAX: [phone] 'A6ES: 3
PHONE: [phone] DATE: 1D/5/2011
RE:
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❑ Urgeit X For Reylew ❑ Please Comment ❑ Please kapiy ❑ Please Racyde
Commems; This Is the adjacent landowner recelpts per our -,orver.satlon,

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CERTIFIED MAIL -- RETL N RECEIPT RE U-ZSTED
DIVISION OF COASTAL MANAGEVMNT
ADJACENT RIPARIAN PROPERTY OWNER STATEMIVT
I hereby certify that I own property adjacent to In )n P
5
r N e of Property Owner)
property located at 3 p� t _ if r"ee
(Lot Block, Ito d, et T�
on —WA
('W'aterbody) (Town and/County)
Applicant's phone Mailing Address: t°0 (Y o.4 40 T
Id e .� —err sir' G
He/She has described to me as shown below the development he/she is proposing at tharlocation,
and I have na objections to the proposal,
...-------------------------------.---_-----
-------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT;
(Individual proposing development n:cr/st fill In description below or attach a site drawing)
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If You bave objections to what is being proposed, you must notify the Division or Coastal Management (DCM) In writing
within 10 days of receipt of this notice, Correspondence should be mailed to 127 Cardinal Drive Eat. Wilmington, NC
DCM representatives can also be contacted at (910) 7W7215,
N response is consIder-eg the same as 119 abiecttorr if You have been netised by Certified Mail
(Property Owner Information)
Signature --
Print or Type Name
PO So o
Mailing Address
Sr)e,�r
City / state / Zip
(Riparian Property Owner Information)
Signature
Print or Type Name
Mailing Address
City / State / Zip

p
Permit #:
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)
Dredge ❑ Fill ❑ B Other ❑
J
V
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 ❑

MITCHELL SEAFOOD
WHOLESALE AND RETAIL
235 WHEELER CREEK RD 910-327-7741
SNEADS FERRY, NC 28480
DATE
Ll rl tJ "-e-
First Citizens
BankCCU"i . M
oa J. 0; f!e m I T`
"'00 10 L 5ii' 1:0 5 3 L00 3001:004 5 7 13 3 38 19u'
1015
66-30/531
457
DOLLARS 8