56513D - Kline

A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary
Date /b''7D —/D
Name of Property Owner Applying for Permit:
/4 O4-i%-j
Mailing Address:
I certify that I have authorized (agent) ��A40L,-"'P ma'-/17e61- dact on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity
at (my property located at)
This certification is valid thru (date) ,2 & /
/Q-2d—/L
P ► 0'+f t nwnar L'lnn']illra nntP

Dame of _n ividual Applying For Permit:
Address 0= Property:
5ui 7,Cc�2 AC -
(Lot Or Street �, Street Or Road, Ci `y o"c CO'`ntt')
1 hereby certify that I Own property adjacent to the above -
referenced property. The individual aonlying for this permit has
described to me as shown on the attached drawing the development
they are Proposing. A description or drawing, with dimensions,
should be provided with this letter.
K
I have no objections to this proposal.
I f VC]L7 h Zra nn; ct i a IS n whaL ; C }�c 1
7a
�Zri ai nn of C'naci-A1 Manaaamcsn' Z ?^ _ (" r�-I n
PI
a y
li Carn7 na
�- () �i bT n
-1 7 al n 3g5 ty
dil[) So,l r}'11n 1 Cl
aIrc n� T-gxn-i-n+- nr t-hi g nr n7 o No r�CnM-gp ;
(�nnGi riardr7 �-S. C
as -if vrs na ro hanr� nn i f i cry ',fir ('cart ; r i cn Ala l
�z TSrn� 9RL"-rT=,
i uade=st=d that .a pier, dock, -moors ai2-j=9S, breakwater, boat
mouse or boat lid- =S- be set bacr a a..z .muu. distaace at ._5' =.-om
are@ Of =-ivarian access - ur-less wa4ved aY me.
tTf you wish co
waive he setback, you Tenn— j .i.tial the aaproprieta blan1: be —lot.)
I do Wish ;.o Waive e
_5 S :'..,3 K --eQL'1Teittent .
7 dr-) ant wish to waive the 151setback- -requitement_

Name Of In i-vidual Apply ' ing For Permit:
Address Of Property:
(� 7
(Lot or S -re C Str--t o r Road, Ci Ly Count".)
I hereby
certify
that I own property ad•ace IlY to
the
referenced property. The individual appl ;n
gTio' this
above -
described
they
to me as
shaven an the attachedy-
drawing the
pe_.1 ras
development
are
sho�;ld be
prcroosin A description o� dra
g '' g, with
dimensions,
provided
with tiffs letter.
V
--
I have
no objectithis pr opos aI .
a a ' t -
-thi a
C •o � _ rc o a
T 0
TT -
uade:=s :ssd toot .a pier, dockp .macro ai.2. izcgs r brearwat� , aoat
aa::se or .boat 1i:! t must bn set ba; is a 4 r _mum d-; t ce of
m,' m ea of riparian access
- unless waived. by .me. t?^
wai've the setbackYou wish to
/ You mint initial the tpg_opriate b?ajY_
Z do wish to waive a
th_. _S Se--�vCK .-eQLiremeIlt.
? tl2nat wish to waive the _1.5isetback xequiament_
1 r
9
Sign Name

OINAM
HILL, SOUTH CAROLINA 29059
AC 8030960027
Toll Free: 1-800-922-7001
State Toll Free: 1-800-845-7051
A0
751
;e r P R.o�J-(
South Atlantic Region 800.
919.
Santee Region 800.
803.
arc

C Division of Coastal Mgt. Habitat Impact Computer Sheet
plicant:�1 �'� Permit
ate:
!scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
Lind 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/o
temp impact
amount
Dredge ❑ Fill Both ❑ Other ❑
�V
15Q
Dredge ❑ Fill Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ OtherAl
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 ❑
n v I _I ni9'2\>2 IT— it A wy 7 " LA o i _ t e-0 1. t0 ►-

LIGHTHOUSE MARINE CONSTRUCTION INC
PO BOX 2532 3922
SURF CITY NC 28445-0028
DATE /%� '-1 �� 66-19/530 NC
PAY 702
TO THE
OR
ORDER OF C-
r1l, dl'W;e- Wr� $
Bankof America
ACH R/T 053000196
FOR
1"00 3 9 2 211■ 1:0 5 3000 19 61: 2 3 700 5 4 1588 711■
OLLARS