78145A_Inglis, Robert_20210415

DIVISION OF COASTAL MANAGEMENT RECEIVED
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED APR 0 5 2021
DCM-EC
I hereby certify that I own property adjacent to 7:pty J or— i57&wrDA) s
(Name of Property Owner)
property located at SOil77l3f10i�i 5/ iy�J21"7tI� 4'itT1 }� /�✓� w�1 +.ST kU �fU~y�jh21�
(Project Site: Address, Lot, Block, Road, etc.)
on ��V�� ►3 �}`% in 1; pe-7m,01 J ,/V C , N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #: Rc)r3c`71l- A, W &I U Mailing Address: P.lo, ?VX Z� /
Agent's phone#: 50� 30 03,29' NI-N17fCI�
He/She has described to me as shown below the development he/she is proposing at that location, and I
have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
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If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252)
264-3901. No response is considered the same as no objection if you have been notified by Certified
Mail.
(Property Owner Information)
Signature
Print or Type Name
P.Drnx :;�!oi/
Mailing Address
1V 01VP4(I,f , i ,MA•-; 0-175-8y
City/State/Zip
,�PK 4 q 0A) 6),15 00 tq7-0W,
Telephone NumberE ail Address
3/)- 6 / 21
Dat
*Valid for one calendar year after signature`
(Adjacent Prope r tnfor n)
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Signature*
Print or Type Name
Mailing Address
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City/State/Zip
Z S' Z 9 eZ -73 5��
Telephone Number/Email Address
3-z�-Zvi/
Date*
Revised Jan. 2017

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED or HAND DELIVERED
I hereby certify that I own property adjacent to "1ttF" 7;WAJ er � � s
(Name of Property Owner)
property located at SOf.I%)t 312019-d fltf1 i'
(Project Site: Address, Lot, Block, Road, etc.)
on 000? 1) �3 ±:Z , in � %15-;I 1A l & C N.C.
(Waterbody)
Agent's Name k TZ tV i36fi T 4, /Ij & 1-1 S
Agent's phone #: 5OS' 3 (, `f D 3J �r
(City/Town and/or County)
Mailing Address: P- 0, ? vX �� t
N tN T C lt, Z el/I- f2,25-g �
He/She has described to me as shown below the development he/she is proposing at that location, and I
have no objections to the proposal.
---------- - - - - -- -
DESCRIPTION AND/OR DRAINING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
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ZIP
/�?�/1� A-7e2z15
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 401 S.
Griffin St., Ste 300, Elizabeth City, NC, 27909. DCM representatives can also be contacted at (252)
264-3901. No response is considered the same as no objection if you have been notified by Certified
Mail.
(Property Owner Information)
jf
_r�� . /Z�
Signature
D092r .Aj 6-415
Print or Type Name
P 0 1 nx 20//
Mailing Address
1V P lV T W F-1- ,W-, o 25 e(l
City/StatelZip
Telepf one Number / Efnail Address
3f�� 2r
Dat6
(Adjacent Prope r }nfor n)
,3 LitJ 17
Signature`
Print or Type Name
��() S�G� r?ri. �i f
Mailing Address
N C -79 3 2-
City/StatetZip
2S2 9?2- -735-a
Telephone Number / Email Address
Date* 3 ~ /
Valid for one calendar year after signature' Revised Jan.2017

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