78095A_Edwards, Steven & Kristi_20210325

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit ,5 ow/r} &Ji 0/1
Mailing Address: I ld—F
� ; U 233aQ
Phone Number: 75 7 — oZ 8 7 — o?t.:�2(o
Email Address: `)iP—v . nom
I certify that I have authorized AJI &i0c*PW U6')
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: o 5 U F 1
at my property located at ai� �o �p� , �Ci¢nci0n i c%9
M��i'truTi.
1 furthermore certify that / 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.
Property Owner Information:
Signature
Print or Type Name
Title
3 / ! / or-
Date
wott54,o�935
This certification is valid through

ADJACENT RIPARIAN PROPERTYOWNERSTATEMENT
I hereby certify that I own property adjacent to �J��jv2 rl iFiLo Util fF 's
.. 1N2mp of Prnnarty OwnerL -
property located at of I b U1 14.1411AN (AC
(Add s
on_ awo-Au in
(Waterbody)
(City/Town andlor County)
The applicant has described to me, as shown below, the development proposed at the above
loc do .
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION NDICR DRAWING OF PROPOSED DEVELOPMENT
ID Rk4
3a5 L-F � (vW4) w /kaeg:&
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,
(Prope O ner Information) (Adjacent Property Owner Information)
Si rare Stytrcr�
P or T pe
rMP~��5t� -a�m7e -ate33�o P�! ,Q�AT ame
dddes V
C
USate2lp Crty/State�ro{-• !1
Telephoneu ber/email address Telephone !Number/email address
3 t 1 r ZA Z{ q .4 / LO Zt
Dare Dare
(Revised Aug. 2014)
*Valid for one calendar year after signature'
6790I15�Q7a (

ADJACENT RIPARIAN PROPE< TY OWNE TATEMENT
E
I hereby certify that I own property adjacent to st9in Fduvfd s
Property located at a(g N(m!pobPro zperty Owner)
L� , (Address, Lot
on , Slock, Road, etc.)
111
(Waterbody) ' In (-r} Qwaz' N.C.
(City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locat n.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
CU Jew
APas_ne
o •.._ �.
aas
LF p� 5FUJ / ba&44
Vun�Q (Jl�l�l¢ud.
u
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.
(Propert770ormation) (Adjacent Property Owner Information)
Ire. r �rure+`
P i or_ pMF
M tkbtA, I P;'(1 oq� T p Name
Mf ng Address 1YMq i g Ad ress
no J�a
o
Ciry_/S7 ` g, $ 7 y I ( I - City/State2rp
Telephone Number/ email address �Tjl
one Number / email address
Date Date'
(Revised Aug. 2014)
'Valid for one calendar vear after signature*

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Perrntr Arrowboad Beech Wa*w
PRC
More nfo
PIN
697011562835
S1TU5 ADD+
218 WINNEBAGO TRL
PROP_DESC
LOT 13,14 SEC L, AB
ACRES
0.39
TWP NAME
ROCKY HOCK
SUBDIVISION
ARROWHEAD BEACH
ZONING CDE
R15
TAXCDE
001IF02
ACCT_NUM
49480
OWNER 1
EDWARDS, STEVEN M -
TR
EDWARDS_ KRISTI D • TR
Ji" -2vt-Y-N
117. �1�..a LQ-(Ces cf.YcOk
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