57423D - McArdle

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
Mailing Address:
Nc- -al
L
I certify that I have authorized (agent) /`1 O{cti t%"N N 11' a -t to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) r0wr py/( r-p p�«
at (my property located at)
This certification is valid thru (date)
60
Property Owner Signature Date

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION[WAIVER FORM
Name of Property Owner:
Address of Property: C-,)0 —Da -c ` QCaw.•�Slt �t d�, lr �w
(Lot or Street #, Street or Road, City & County)
Applicant phone #: %Ott- 30�� g�0`%� Mailing Address: 38gAn FVi�546.., �
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.
VI 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.net/contact 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
� h�
Signature
Print or Type Name
38a (�;�,-� .
Mailing Address
(Riparian Property Owner Information)
Signature
Print or Type Name
/3oo West-
Mailing Address

30
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
Address of Property: '9'g ])'�r� Own�'it ��aw�� _T�t'yi►ry
(Lot or Street #, Street or Road, City & County)
Applicant phone #: ?� �� �� I� �'[.�" Mailing Address: —VZ') is dam,. 0.
riG Cc A.). CO
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 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature V
Print or Type Name
Mailing Address
(Ri arian Property Owner Information)
Signature
(2Ar l A, W -
Print or Type Name
119 qu.-�-�: ,
Mailing Address

Division of Coastal Mgt. Habitat Impact Computer Sheet
licant: wa" �S G�'- Permit #:
gibe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
id 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 ❑ Both ❑ Other
a �
I a
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 ❑
7�- G ./ if - —

First Bank
Shallotte, North Carolina 28470
ITS BETTER BUILT INC. 66-456/531
4287 Carolyn A,� 8/
Sh.11.tte, NC 28470
[phone]
PAY TO THE
ORDER OF NCDENR
Two Hundred and 00/100`—`—'—'��***� '
NCDENR
FOR 51+93D �bz--)
28 Dare
11,0019420 1:0S3104S681:
DOCUMENT
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