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Home My WebLink About57486D - Riverbend 24/2011 10:46 9102871133 P GOLF CONST PAGE Achad F. E 0eY&W, VA- WA NCDDW No►g, China a nt of Environment and Natural Resources t)lvisNn of Coastal Mansgvnent Chartas S. Janes, Director Authorized Agent Content Agreement Wiliam: G. Row ir., Seaetm (nlz!w UArAQffi is hereby authorized to act on my behatf-i (F&ftd Naff* of Agent) i order to obtain any LAMA permit(s) required for the property listed below. The authorization is limited to the ,peciflc activities described in the attached sketch. .0CA-n0N OF PROJECT; �46 A.OeAie�-� 'ROPERTY OWNER MAILING ADDRESS. /o r!!� / �5- WTHORIZED AGENT MAELENG ADDRESS: i�S74 Mo z5#� 19tic.k E tvikg S�vjel�j /VC. Q'84(pif a a >igneture of Property gamer P'igrtature of Authorized oaten —�f PHON1E AEG. Z±' Z — ,.—0 5 4> PHONE NO, w_ _W, - ` a2 y ?9 11 09:07p Jim Godwin 910 270 4627 p.1 DIVISION, OF COASTAL (MANAGEMENT ADJA ENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAI'vER FORM Name of Individual Applying For Permit: UQr eoS iG it o # 5 io1 Address of Property:_ 6 & U grb (Lot or Street #, Street or Road) vn (City and County) I hereby certify that I own property adjacent to the above -referenced property. The individw applying for this permit has described to me as shown on the attached drawing the development the' are proposing. A description or drawing, with dime ions, should be provided with this letter. t�7so,� tA� � u- D/3sT.t u cT Y Vi6af CAV.�-g �5 I have no objections to this,nroposal. ray W9%��,etpr o.< i4m.1.�h,/ ,V4r If you have objections to what is being proposed, please write the Division of Coasts .Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or ca11 910-395-390( within 10 days of receipt of this notice. No response is considered the same as no objection ii you have been notified by Certified Mail. oic WAIVER SECTION 2 ! �-- I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift inust be set bck 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. (WU-1 W Y1z-r11, S i ,-n Name �- Date �7#vl� W6676V d� Print Name 24/2011 10:46 9102871133 P GOLF CONST PAGE 0; 4�-.) d6�-- ex�5t* `tX►bi&m� x { uverej hfa Division of Coastal Mgt. Habitat Impact Computer Sheet cant:i v��ev�cl Shall o LL-C- Permit #: P S-j 11 qk ribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement i in your Habitat code sheet. at 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 ❑ 2 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 ❑ ARNAMS DOCKS & BULKHEADS INC 1574 MONSTER BUCK ESTATES SUPPLY, NC 28462 910-755-6861 DATE I 6382 66-112/531 12 S. a '. BRANCH BANKJNG AND TRUST COMPANY A 1-MO-S800-BANK 88T BBT.eom I erm4NP ��P, i (. /""--� ll■00006382ii■ ':053101121':0005215 u■ ■ Complete items 1, 2, and 3. Also complete A. 7Received item 4 if Restricted Delivery is desired. ■ Print your name and address on tMe reverse- Xso that we can return the card to you. B. y (Printed ame) C. C ■ Attach this card to the back of the mailpiece, or on the front if space permits. N I. Article Address to: 5� P.ed FuX Tro-J N-o0,0101 NC 38g13 fihkilB:all SHALLOTTE POSTAL STORE .AL:iOv'.t`X:+Sfn:`:v SHALLOTTE, North Carolina 284704459 3613950459 -0096 11 (800)275-8777 03:48:53 PM — Sales Receipt Sale Unit Final on Qty Price Price r: Nr 28470 $0.44 'St -Class d Delivery: Thu C8/25,11 Rcpt (Green Card) ad .g5 70081830O0020�E4922k85 VI: W5,54 D NC 28443 irst-Class :± Delivery: Thu 08/25/11 Rcpt (Green Card) $2.30 ad $2.85 70081830000205492830 !i 1: $5.59 $11.18 t #: XXXXXXXXXXXX0802 �l #: 84758C tion #: 552 D. Is delivery address different from item 1? If YES, enter delivery address below: 3. Service Type ❑ Certified Mail ❑ Registered ❑ Insured Mail ❑ Express Mail ❑ Return Receipt for 13 C.O.D. 4. Restricted Delivery? (Extra Fee) Number — ferfromservicelabel) 7008 1830 0002 0549 2830 13811, February 2004 Domestic Retum Receipt to .0 1 Service,,, (Domesticro Only; nj Er Ln Postage $ Certified Fee r-!.`, ru 0 Return Receipt Fee Postmark O (Endorsement Required)•!-f Here O Restricted Delivery Fee 0 (Endorsement Required) m CO Total Postage & Fees $ )?� i co Pnt 5cpll 0 . ----- --- --- ----------------- --- T_ .- Street, Apt. No.; % or PO Box No. `1(2 A � 0 .. m CO ru u7 Postage ED Certified Fee fU 0 Return Receipt Fee 0 (Endorsement Required) l-3 Restricted Delivery Fee C3 (Endorsement Required)