79412A_Colerain Beach, Inc_20210820

RECEIVED
DIVISION OF COASTAL MANAGEMENT MAY 2 4 2021
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
DCM-EC
I hereby certify that I own property adjacent to �e;dv -7%4
a
ame of Property O )property located at -1 2 oye h�� yLe4ie 6V
Project Site: Address, Lot, Block, Road, etc.)
on rl 6&1 , in , N.C.
(Waterbody)
Agent's Name #:
Agent's phone #:
(City/Town and/or County)
Mailing Address:
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)
1he bd A41A,
4 davw Am
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.
Info
Signature
Print or Type Name
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City/State/Zip
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Telephone Number /Email Address
(Adjagpnl property Owner Information)
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Print or Type Name
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Mailing Address
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City/State/Zip
75�7- 299 i/oo
Telephone Number /Email Address

RECEIVED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM MAY 2 4 2021
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERED
CM -EC
I hereby certify that I own property adjacent to IN 1 d, 's
A . „ (Name of Property Owner)
property located at
(Project Site: Address, ot, Block, Road, etc.)
on in Cl! ( r`7,7' CO N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #:
Agent's phone #:
Mailing Address:
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)
(� a`T i,�ak�
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 _
(Pr ert caner Information)
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Signature
Print or Type Name
PC) 3gy37
Mailing Address ,�6
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City/State/Zip
Telephone Number / Email Address
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Print or Type Name
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Mailing Address
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City/State/Zip
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Telephone Number / Email Address

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