Shew, Michael 80408C

Emailing: Image (183).jpg
LAMA / DREDGE & FILL _ 9 80408 A B 00
ENE L PERMIT Previous permit#
'New ❑Madification CComplete Reissue ,.E;R al Reissue Date prev ous permit Is ued
As authorized by the State of North Carolina, Department of Environmental Quality r
and the Coastal Resources C mmission n an area onmental concern pursuant to I SA NCAC
Rulru atmcfi d
Applicant Name Project Location: County
Addr� t4 I Street AdSWsS State Road/ Lot #(a)
Phone #!�' r _ _
fA
l Subil n-
_
ril
Authorized Agent t �y' __ Clry _ ZIP
Affected " Cw C)ES ❑/t/S Phone# ver i
AECs: ❑OEA HF❑UBA ❑W
O Pws: Adj. Wtr. Body- "
ORW: / no PNA yes /0 Close^st Maj. Wtr. B _.
Type af Project! Activity /rim --'�Y. I _.i/ / //p - "l1 / 1
(Staley Ic.f )
Pier (dock) length - -, _ _ _
floating Platform s -' ` 1 -� ✓ I - , --1
i+
Finger per(a) �1
Groin lenglr�
BuNheaN Rlprap length
av8distanwolfshwe
m distance offshore
_
asin, net
cubic rarer------(1�
;.I
13 ramp_
Banhousd BwJifP�—�
Beach Bulldozing
Other
ShordincUryeh
SAY: IKK6Yre yet i... ..... .. . __
Mwatodum: Na yas ._.. _, �. ...
Photos: yet .. y✓�f
A building
t may 6a wired b : - - . /. a /rl / /n !I Is.
g perm' y required note on back regarding River Basin rules.
(Note Local Planning junsdlction)^. v, ,� Q �f
Signature -7�
Is3 Da 1
2 of 3 5/24/2021, 11:08 AM

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Reqi
Mailing Address:
Phone Number:
Email Address:
ZI
I certify that I have authorized Jotl a iai, 'Iopal (tea5l al
to act on my behalf, for the purpose of applying for and obtainin all CAMA permits
necessary for the following Rroposed development: f
n, Dh D , , I A I _ _ . �J
at y, prT
rty to ted at
1
in ✓ / rCounty.
I 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 to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
�4)0i 0.
Title
Date
This certification is valid through I I

I hereby certify that I own property adjacent to C J s
property located at Pr
dame o �ro r
�� C f,QL- (Add►esn
on Q
, I 1 0 7�ir('e. N.C.
The app • nt has described to me, as shown below, the development proposed at the above
tocado .l
t I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT t
(Individual proposing development must NN in dsxw* tton below or attach a a#& drawing)
I,) I
L=
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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 yoy wish to waive the setback, you must Initial the appropriate blank below.)
V/ 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Si17ruX . L �� F
Pint rl 00 Na 7
�2,7
c tern ,
ea,(Vu r/emalladdress
Date ((
Telephone Number/email address
D et'
(Revised Aug. 2014)
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I hereby certify that I own Iproperty adjacent to All chat � 's
propertykocated at G%''f �.-��,ir
�e�rrwwn�r■���_..
The ap icant has described to me, as shown below, the development proposed at the above
locati
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Ind/vldua/ proposing development muse Hit In dascrlpelon below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.
address
(Adjacent Property Owner Information)
o �—
f s
Yl Alc —,-a'S tS`/
�"l�-2 - �1? 3 - Y'� , ;'
Telephgno Number/email address
17 +zt( )14, 21,z/
(Revised Aug. 2014)