76567D - Caravati

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}CAMA / ❑DREDGE & FILL N9 76567 A B
aENERAL PERMIT Previous permit#
INew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
ized by the State of North Carolina, Department of Environmental Quality
:oastal Resources Commission in an area of environmental concern pursuant to ISA NCAC 1 :3-OOt.)
��, ❑Rules attached.
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to C I - :, s
(Name of Property Owner)
property located at . 13 aJ, I % I r A. - —
(Addross,Lot, Road, etc.)
�"�`cl�� , in (,��, r--,, �,`1,,,_2 , N.C.
on (Wafiertxdy) 1 (City/t�own andior County)
The applicantpl has described to me, as shown below, the development proposed at the above location.
J I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Se r ( "
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15 from my area of riparian acriss unless waived by me. (If you wish to waive
the setback, you must initial the appropriate blank below.)
C..) I do wish to waive the 15'setback requirement.
I do not wish to waive the 15' setback requirement.
(Property r Information) . (Adjacent Property Owner Information)
y1-rA- Inform,
, ` LL.
/r Sign hre
signature 2«cc�t 1-k. L. 13 LA-L.‹.r-
Print or Tyrpa-Name Print or Type Name
4,1.1111,6 Mailing Address ( t
A, n i 7C k 1 f \_ N.. -kzv1 Al C .�R l i t --'u2JE-4, .k,�a�b-L4c,

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to C`'1,kr I i ( a,-ca v SY _s
(Name of Property Owner)
property located at _ d _t�F•ti,1,-5 j� ,� --.-
(Address,Lot, Block, Road etc.)
on 1 1;c1dit <C . CI , in 6.-1;11,,. �< tl",., , N.C.
(Waterbody) (Cityfl>own and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
,✓ I have no objection to this proposal.
I have objections to this proposal_
DESCRIPTIONAND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15 from my area of riparian access unless waived by me. (If you wish to waive
the stack, 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.
(Property Owner Information) - (Adjacent Property Owner 1 tion) • E 841"
goLe_41..,L .6A/P�'' 1
Signature Si
Print or Type Name Print or 7e me / �(�, j
Mailing Mailing Add t?(� firvA(-)
5---,r7 f d r d ��
(.0l�L, Alt .Z"7 L D?'
City/State/Zip City/State/Zip
C7/91)d^Z ,..5-6-057

Check
en(Name) Name of Permit Holder Vendor CMek Number amount Ppmlt Number/Comments Receipt or Refund/Reallocated
•
anal Column4 Column6 Column6 CMtann7 Colum,M Column9
lh Gay Douglas Gay First Bank 1223 S 200.00[GP/77824D JD rct.10825
en Urso same Wells Fargo - -- 998 S 400.00 GP*71875D JD rct.10849
Bulkheads LLC Charles Cavavati Wells Fargo 23491 S 200.00 GP/76567D j KE rct.10850
,onstruction.Inc. Kevin and Lisa Armstrong BBBT 22793 S 600.00 GP/77843D I BB rct.11541

From: Jimmy North pmmymnorth@gmail com
;ubject:
Date: August 13,2020 at 12:56 PM
To: [e-mail]
P4r4,11, ,
, c ir ,
,...

1111 8/2 01 9 Agent Authorization [e-mail]-Gmad
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Cite,44Name of Property Owner Requesting Permit: IBC L
Mailing Address: 3 I Rc> Kt)
Phone Number: ,i'eLf 3 64 3 l 6 S
Email Address: C CA p Vk ( i LowEekbckEgaiol , t
I certify that I have authorized f 1, t� .-1 /` '
Agent f Contractor
to act on my behalf. for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
4- l—
at my property located at 1 J a 14
in /0f.•.o County.
I furthermore certify that I am authorized to grant, and do in fact grant permissior
Division of Coastal Management staff, the Local Permit Officer and their agents to et
on the aforementioned lands in connection with evaluating information related to
permit application.
Property Owner Information:
nairre
C e- +� �
Print or Type Name
, 1.- ,�