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Home My WebLink AboutMoeller, Thomas 76787CLAMA / DHEDGE •FILL NO. in GENERAL PERMIT A A m D Pee,,. .• _.M Ai . '...C.pl .Bmave -Pv Ptlsaye Dr Pp prbk A..IIIMlE%Y $flYdNaN GetLM D�IPr1dirntic+nvnL(Aol', YAWe Cmollmacb Cmnarn a.n rnaaMvnrvl mram pavaMb lSA NfAC 07H A200 Appeu,PA _ T)amas Moeller_______ p.pptt LpDpgy Ca.n4 .CarSe_reS—__.____.__ Pdd.118_N_i fttea_DrNe ____— Soeee Adtrmy kPAsoPN Ltt s(s) sWlle CAy Phe KI_wN Slnres_ _ y�NC_ Zr 28516 PMn.•t@1413835894 err—.—__ __ -. s�camooa.. _._. -___—. __ . AwAWmAg—-WAOtd1NDmd9Lnp _._ ClY __. LP—... A ,x .aw Xw Xn• ':n arse Proms ()__. _ u 6,,Wtft Osk �wi _� iW r'N JU -lWA MI. WV. /.��E@118� _ NllAlxlAMN OAW: re. I D{ PPlA P ! 16 Clmev I'1i.Wv. Bad/ BNw $OU1b _ Trna a P-*V AaMky orosessd dock PM(AN11rya. SEA_ X.NPMbMq -_.� na.q PmrMa �.. &.awPBpp Yqa _ «eaugd6m.= nv. M.o dd� ma.va_ coop -PKS anal - _.. PrO sed�HOf111 --... exisOng WlNffead .. _. rw.rm m n � P1ae� r^ )Q Moeller WwrA.ydit p b Awwa�bnWrz br PKS ( rlau lary Pdeayp.lncaonl Nae../sPmYCaele.eP Nle _n Bames Bred Connell Ana An Farms hnWC9[Y.Pwtl /� aadd�.rK.le �vd i.mmdpo-na c-- SaS� _ $200.00 a 10148 711WO _ 1111420 +P.e+.araa a.... e.�.aab bmr.»aoiw AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Property Owner Requesting Permit: -T-ho MIIS t✓_. iyl-r ! b_ MUer Lev - Mailing Address: jig (barV 1 'i`a -��— Pioe� Knott 6boreS. NC- 2$S12 Phone Number: -! 14 - 3 y 3 J�rrri ] Email Address: Moeller Q 1 UYlO Co rn I certify that I have authorized Mud I hC Agent I Contractor to act on my behalf, for the purpose of applying for and obtaining all C'AMr A permits necessary for the following proposed development: JrX ZO i� a q s �o-f Dock at my property located at o g Arbo ry i +a—e— %% r/ V P KS in&r+-e_r4_ " County. 1 furthermore certify that I am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents r on the aforementioned lands in connection with evaluating information atQd _t2this permit application. Property nerinform o ignature Thvmas Mo,&-(Ie►- Print or Type Name wne° Y / Title ,.nl REc ED Date 'CITY This certification is valid through I I ADJACENT RIPARIAN PROPERTY OWNER STATEMENT J I hereby certify that I own property adjacent to I 7OjM A. r 's Name of Property Owner) property located at 1 I$ �(bo r V t i 4 e, Dely m. - (Address, Lot, Block, , etc.) on Arne, Knol ! (/iilAfi2YWGLN , in �� n P Zn)$tio rGS , N.C. (Waterbody� (City/Town andlor County) The applicant has described to me, as shown below, the development proposed at the above I tion. have no objection to this proposal. ---_—�I I avjQctioo,9to-tttis_prnp�zsaL----------- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (Individual proposing development must fill in description below or attach a site drawing) ?Ke>po % E D I c ! Sic 20 1406, SLAT DoGK F'cISTW 4 ><wf IC-AyA►,- TrNG Dccl< ►AuNGF•1 p� u _ WAIVER SECTION_ -- -- 1 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 setback, 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. Print or Type Name II I Arborvl+4e- Dr Date roperty Owner Information) lI Print or I ype Name /ao 4le16DRUI��_! Maij�g Addr ss / Ve ItSjl ell ZSSI2 Pine'nc l/ ShorPb / City/sf 2ip Telephone Number --are to '// a 10 E E RIVED D (Bevis JUN110 A0 DCM.MHD CITY ADJACENT RIPARIAN PROPERTY OWNER STATMENT I hereby certify that I own property adjacent to l i'] PM A 5 AA OP Ile r 's (Name of Property Owner) property located at FA (Address, Lot, Block, ad, etc.) on?fine.Kno►l waQ eYtnway , in p1 1 �nn� ll 7hoY-e-S , N.C. (Waterbody) (City/Town andlor County) The applicant has described to me, as shown below, the development proposed at the above locatioy�. ✓ 1 have no objection to this proposal. I have obi-eQticns-- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMEN I (individual proposing development must fill in description below or attach a site drawing) f`� t1¢pPo S E A Sx �® I�oea SL.A"i D �GK EcISTIN4 1 LOd .TING DOCK jAUiJGk PJD WAIVER SECTION, — I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set ck a min' um distance of 15' from my area of riparian access unless waived by me. (If you wi to wpithe setback, you must initial the appropriate blank below.) "1�/�II do wish to waive the 15' setback requirement. I do not wish to waive the 15' setback requirement. Owner Date (Adjacent or C 2-851-1- Name information) Cfty/Statelzip AJn Telephone Number /'C� D � - a • a�/>__ D 9 IVIED Date (Revis IJ V 20S 0CM-MHD CITY