57317D - Westbrook

07 11 06:39a Paula Davis Noell
e6. 16. N11 4:36PM MUM RH YMATOLOCY
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919 969 1108 P.3
No.434� P. 3
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07 11 08; 39a Paula Davis moll 919 969 1101B P. 2
ADJACENT WAR1AN PROPERTY OWNER STATEMENT
(FOR A PIERJMOORINc plL.lAUVROA-fUPT19 ATHOUSE)
s hereby'`Wi�y [hill J own property adj4OtRt to -.41Z .'?., %�` !i2 . 's
(game of Property Owns r)
pr'oprm located at jr:-C. Tt rL�t
II (Lot, Blocky Rood, etc.)
on CCL1iCILk in �l[ UtG ` 15I40T,N.C.
(Watrrbody) own auftr Counly)
He has described to Fw, as shown below, the development be it pmposing at that location,
rod_ t knve no objcctinr}ti tO bis prpposal- L uoderstandthat apicdmaoringpi]inSVtw a bftfbeathousr
must be set back a minimum distwict of fifteen feet (15'1 from my area of riparian ac;ess upless
%aiv ed by me.
1 do 3]91 wish rn waive [hc setb"- requirement.
_. i y'q wish to waive that utback requiremult.
— - -- -- - —. ...�.�. --- - -------------
DESCRIPTION ANDIOR DRAW LNG OF PROPOSED DEVELOPMENT:
fTo berafled io by in&vid—1 prop-ing d—lophrerul
1CC(
- --------------------------------------
priftl or l
Type N�ame
Telephone Number
Date: —1014!�t4z 6,
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Division of Coastal Mgt. Habitat Impact Computer Sheet
)licant: -TG
n (,vLS Permit #: 5:73 /--7
e:
W
I OW
cribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
rid in your Habitat code sheet.
DISTURB TYPE
itat Name 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
impactamount)
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)
�v
Dredge ❑ Fill ❑ Both ❑ Other
�ir5
3 `' ✓
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 ❑

CLEMENTS MARINE CONSTRUCTION INC +...
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