53160D - Buttner

PAMA / 1DREDGE & FILL y
iENEL PERMIT Previous permit #
Chew Modification EComplete Reissue EPartial Reissue Date previous permit issued
zed by the State of North Carolina, Department of Environment and Natural Resources �}
)astal Resources Commission in an area of environmental concern pursuant to 15A NCAC r I
N� Q Rules attached.
Name
QC-T- VJ WCO: State O',A ZIP LJ 2t3JO
11a SAS Fax # ( )
d Agent ; %--s Uy 5, C
❑ CW ❑ EW ❑ PTA >�ES ❑ PTS
❑ OEA ❑ HHF IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
Project Location: County�L.��
Street Address/ State Road/ Lot #(s)
Subdivision ©Spt1��j
City �J • zip ,2•-:c q U
Phone # () River Basin W N i ti
Adj. `PVtr. Body�L^M P _(n� . /m
Closist Maj. Wtr. Body A L Y� �✓
es / no PNA! yes no Crit.Hab. yes / no r
Project/ Activity 7 � "�v� t_ LT,o cz�` h/<Z's�ut N
(Scale: : Z
k) length
s) —
.r(s)
gth
fiber
/ Riprap length Q Li
distance offshore
: distance offshore f
innel
is yards
P
e/ Boatlift
�.
Ildozing _ _
J
Length
not sur yes
no
not sure yes
0
um: n/a yes
GD
yes
itached: yes
nq�
ig permit may be required by: N'
AL\-\-
❑ See note on back regarding River Basin ru
;oecial Conditions S\\ i"1LL
" c. W 1- r_
\A L
xk, \L,a `-w .311.,.E aiLi

ax - Marianne K Buttner Tc.John Cassidy (19103276353) 12:31 01106/C9GMT-05 Pq 02-02
FROM : Pi 1 inss Ard More FWc NO. :910327 3 1an. wS A209. E5: e6Pt{ P_
MA
NCDENR
NuAt f,;wLkia D aiui)tii)I u! E iJi r)i'iie'"ail Natural Rmurws
Division of Coastal Management
hkc m E. Ens". Gown or James H. Gregson, Director VA"I G. RM jr, seenrmry
hate _X �N 02
)game of Prooetfi Owaes Applyiaa [or Permit_
Mailing Address:
e, 12! LJ FO�'`i J, /Y Y6�h
1 certib- that I have authorised (agent) J`oy� GA.tf�r rT.t' _ to act on nky
behalf, for the purpose of applying for and obtaining all CA'KA Permits necessary to
install or construct (activity) RocOYM
as (my property located at) AgZ )31' J /"• A J ! _
Nc o'gf�J'r0
This certification is valid thra (dgte} ��i*'-�' � �� ,�_.
Property Owner Signature Date
127 Ganiinal Ohre Ext., W[Wiirigion, With Oam.Ara 28405.3W

!an 06 00 10:4^a
"ROM : P i j i rios And More
FAX M0. :91032-,S-353 Jan. 05 2(0 06:18PM PI
P.2
/- a
CERTIFIED ;[AIL - RETURN RECEIPT REQUESTER
* C--;� DIVISION OF COA +TAL ,MANASI&MENT
ADJACENT RIPARIAN PROP,Fgn Q1YNER NO FICAT'.0—MAIVER FORM
Tate purpose of this form is to provide proper notice to yec as an adjacent !gip er. xoperr,, owner to the ind;vidwsl or
indivicuals fisted below. The C.AMA Genera! Perrn!t application procedures rcgLire that applicants provide die Divisiun of
waStai management conttrrnauvn ttuu .: wrMrn s«Ir;rlrt!t WL, Liam untwneu alWaw uy wL duj"cixi ripdnan prvpeny uwnerb
indicaund that they have no objection to the proposed work or tiat the adjacent -iparan property owners have been notified
ty rrrrit;Prt mast of thr ^rr>rncaA wnrlt ;1Rt;n three ennn5 ar, �ihrnit*ri� �A the a�toe�rlt riparihn lil'npGtrY 11Wnkr5 h7 h ttwine
r^.ntrvPtrr nrni4iPr inriiv!dt:n!S nrta� RS nn Y.IIthAMPr! ayPnl hn hPhAIfAT rhP Atlrllrarr
Tbis form was sent to you by the fallowing individual or company designated by the applicant 2s sn
aatbori2ed agtat:
�
,r o
Aacttt' i arure Date
ymg
Andress ofProperty. 0/.7- BS�/�y
(Lot or Street l`. Street or Roa
(City and County)
has cescribed tc me as or, the attached drowirtg the developme;tt .hek are proposing. A description or drawing.
t have no objections to this proposal
�"arain'aa urrvi! `rctiZrs�otr, v:tltulitg�il4•��6`s�3�'L. gle�2i�.!�Te tl1RJ�.[KiSJriJ"_0� C�JtASLa!_ _Ys enxzelnetrt. 127
No response is considered the same as no objection if you have beta notified by Certified stall.
L understand tb:tt a pier, dock. mooring pilings, breakwater, boat house or boat lift must be set back a
Rti:Itmuni d(bieucr ui 15' it vu, aie] a:%a of .,> AviAa t4tieg unlaas wamled bil me (If you ntich t^ 5vuhfs the
... .... ...... �.._. L:r:nl An ► vnnrintp e* W
,p (coo wish to waive the i� �'�llSrN reruiremrni. �
I do no wish to waive the ? 5' setback requirernent E 1 r .'
lap vv 5.
'Sign Name Lute "� �r$` Irl��
y /, .�.+ c.,,e... you -� • a
`ielephone Nurtiber with Area Code

Inn 06 09 1O:40a
� /y
.� Atl►Af"fiN7 RIPARl4;v PRt)PAS Af.`t NA
— - RLy o WN£g NQTTFrrATlrzhlnar,t_R, y rot
aI
The purpose of this form is to provide proper notice :o you as an adjacent riparian property owner cc td3o individual or
...1:...1. it I:11_3 Maw. Tha C.11.t a. la tt"i'al r1b.'.p,J ai1�!lldfltS31. y }:t�asut�as twquire thae apysliretla i .b.:.t t1._ v,
Coastal Management confirmation that a written statement has been obtained simled by the adjacent ripanar, properry owners
mdieating that they have no objection to the proposed work nr that the adjacenr riparian property o,Arers have been notlfted
by ctxtifted malt of the proposed work. Oftetr these forms are submitted to the adjacent riparian ptoperry owners by a mari contractor or other individuals acting 1s an aucharizvd agent on behalf of the applicant. ne
This form was sent to you by tha following iodividual or company designated by the applicant as pia
authorized agenr: _
31 , 0Vol
AUthOrrJ
C4 A¢ i 14t1Anrrr
Na3ne of Individual Applying For Pcrrnl :,- fL A10vrc
Address of Property: '40 /'— r 1-1 (00W--r Mk e i7r w >' `;-f�� -
mm"1'C6t ar street �. S nett or Road)
_MA., rI, , e AJ♦
(Cin• and Coup v)
1 hereby certify that 1 own proce adinPont t, rk..3..+......c.,.... — Gowly rtty, ,Qr mm perm, IT
cw uescr!oea to me as Chown on the aaached drawing the de OTTIC"t ;lieu are prooasing. A descriprion or drawing,
with dimensions_ should be provided with thic leant
+vim i have no objections m this proposal
If you hsve objections to what is beingg ropposed. oiease write th. n:.,t.:,,.. _e ,a_....` ... , ;ir
catut,tai ut t.0 n.xtenston, %umtngton. ;`;� 284D-4 or call 510-796-7215 within 10 days of receipr of ibis notice.
!No response is considered the same as no objection if you have been notifl'ad by Certified y[aiL
1 understand that a pier, dock, mooring pilings, breakwater, bait house or boat lift must be set back a
minimum distance of 15' from my area of riparian access - unless w9ived by nne. (If you wisb to waive the
setback, you must initial the approgrlare blank below.)
l do wish to waive the 15' setback requirement
1 do no wish cdwaive.the 15'setback requirernertr. yt'a
sip�n Name Vale
!- Y f4gK73ttrt' L'1l t6TTx. R'SrRO.KeJ
.Priat Name
Telephone Number withAreaCode
p.4
'f- 1 _ CERT!n D MAID, - RETI URN R, ('x'1i'r3^r

',--
PILINGS AND MORE
JOHN CASSIDY
16 LAKE
S27-2009
HAVEN DRIVE
SNEADS FERRY,
� NC 28460
DS
P Yto the �C�i'��
o order o
5312
6s-3015�
Unte
9Oa,po
Dollars 8 °
fi First Citizens
f� Bank __--
firstcitizens.com
For
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i:O53 L003001. 457 L3270