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07 11 10:38a Reginald StrioWand
NOM Carotins DQP*ma t of Ent
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Date
N"W a[Pnl" Owner Apoyft for
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910 17Nil
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I certify *at I lt8a ow,orWd (aqmt)I'd) 1/1,IX v P to act on nay
bell, [or the purpose of xpplyig lW MW04M uning 82 CAM Pe uft uuoaasury to
baatm cr omouet (seeW*) C "
iltis emdstanab is ram thro (a*e) L _
Verner Signmrs
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!C Division of Coastal &19t, Habitat impact Computer Sheet
1 �L _ ��,i
pp►icant: awt4 v'�1 1 v� Permit #:
ate:
ascribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
and in your Habitat code sheet.
ibitat 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 ElOther
El
--1111
3Z�
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 ❑

DIVISION OF COASTAL MANAGEMENT
ADJACENJ RIPARIAN PROPERTY OWNERT1F1t;ATQN FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own primly adjacent to 61 's
(Name of Property Owner)
property located ati
(Address, Lot, Skack, Road, etc.)
on— ,4 C A%a in ,��' ' l� �' -- N.C.
(Niamey) (Clty/Town and/or County)
Agent's Name # �r�t/'1�(n ��� � e 5' Mailing Address: -ro A; 1 1,4
Agent's phone #:
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fIl! In description below or attach a site drawing)
If you have objections to what Is being proposed, you must notify ft Division of Coastal ilbnagemeM
(DCAI) In writing whWn 10 days of receipt of this notice. Coftw udbimadon for DGN oMes Is
evel/able Of www nccaesWmangementnedcontact dcm.htm or by calling 1.888dRCOAST. No
I
s con kiwi the some as no N Ym have Own no~ b ConWed AWl.
(ProperivOmer Information)
Signaru
rafr P /r � -1r,,'t k lah,
Print or Type Name
Meiling Address - - / -
(Riparian Properly Owner Infonnatkm)
' Srgrraft}ig
Pro or Type Name
VaNng Addmess

07 11 10:38a Rsginald Strickland
E•yB1.�sL�i:rk� . a
MAL -
i txmby certtly #tat I o*n omperty
PvPe" bMad at ICal
(Addr=a, Let,
,on___-- in
MANAGEMENT
y Road, etc.)
.S"r.4 c a
{Name or PraPW* pwtW)
N.C_
(wakw odr) JOHt ltown andkw County)
Agent's Mane *. -fan Ao --\ ldaAktpAdds>ms: &�Ce 1"elf
AMOs phone d: /G' T YG I 3l� �.� �� ,• 1 ;�� , ��{ `/, �1 '
Her*he hac dam4dmd tD me as shown baIow tho t he/she is proposing art that be Oon,
and I Mdwe na abiourma 10 ft proposal_
C ESMPTK)N ANIXOR DRAVA OF PRL1POS19D OEVE'LO MENT
11n t oh"Uoi P"ve" davorOPM& sweat N1/ � bNaw or ei[sch s solo drewiisy)
MFr halm abjectfma to ~is bokgprepm"
(Dm la wrl*v *Man sd d"3 of t a1
amwbob of wowimw0asoInramnVOa,Lnrife�
(Prq*Oy Owner in
f
+�a-rtt� S�ri� ia.r3�
PM or type
Nirm—
Ad&,=
trio le we ru
c�WO O'D
raiwo a Harsher
rwW*. CWW" Wroia"&W rbr DW tN&= is
(R aProperty Owr In�armstiart)
Pnw or bb& Name
!zt� 'c
ss
G 1 grit �7slb
co /- ry
I `I r 9(P `] - Y{G l
raimprxww Aftmoor

ivisjon of Coast2l higt. Habitat Impact Computer Sheet
int: ���ahand- Permit #:
VI,F Y l��` �/ t
)e below the HABITAT disturbances for the application. All values should rndv,lw the name, and units of mews"rement
in your Habitat code sheet. FINAL Feet-�
I DISTURB TYPE
it Name Choose One
Dredge ❑ Fill V Both ❑ Other ❑
Dredge ❑ FIIIXBoth ❑ Other ❑❑ Other ❑
D-.:dge El Fill El Both ❑ Other �!
Dredge
Fill ❑
Both [I
Other El
Dredge ❑
Fill El
Both El
Other El
Dredge ❑
Fill ❑
Both [I
Other El
Dredge ❑
Fill El
Both ❑
Other El
Dredge ❑
Fill ❑
Both El
Other ❑
Dredge ❑
Fill ❑
Both [I
Other El
Dredge ❑
Fill ❑
Both El
Other ❑
Dredge ❑
Fill ❑
Both El
Other ❑
Dredge ❑
Fill ❑
Both 0
Other El
Dredge ❑
Fill El
Both ❑
Other El
Dredge ❑
Fill ❑
Both ❑
Other El
Dredge ❑
Fill El
Both 0
Other El
OTA'_ � Tq. Ft.
FINAL Sq. Ft.
Applied for.
(Anticipated final
Disturbance total
disturbance.
includes any
Excludes any
anticipated
restoration
restoration or
and/or temp
impact amount)
>a's
TOTAL Feet
(Anticipated final
(Applied fort
Disturbancence.
total includes
any
and/or
any anticipattion
restoration
pact
temp impactt)

B AND B MARINE CONSTRUCTION
1168 COREY DRIVE
WILLIAMSTON, NC 27892
PAY
TO THE
ORDER OF
0
MwACHOvta
Wachovla Bank, a dlvlslon of Wells Fargo Bank NA
II00 L L9 2no I:053000 2 L9': 20000544487001I'
1192
66-21/530
V BRANCH 77639
DATE J
$ 6Oe. 6 b
am