HomeMy WebLinkAbout84523C - Topsail Beach Legacy LLCaN`� �CAMA ❑DREDGE & FILL N° 84523 A B (c) D
Previous permit
GENERAL PERMIT Date previous permitissued
New ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by]the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
�
I SA NCAC �''1 k •I2,136 ❑ Rules attached. 54 General Permit Rules available at the following link:w degncyov/CAMArules
Applicant Name IUrYtf( IXiNA! 1 Q('11 LLL i PINK-V 1C14rNT/CY'
Address I I I S' A) 410 120-
City VfA61 },-USV,JL6 State_ LZ ZIP 6
Phone # (� '210 IA
Authorized Agent
Project Location (County)' —obsto ^^
Street Address/State Road/Lot #(s) 51 Vtl LV I F 1/C -
Email VMPHIN1
V 61U+JL,eAMM
Subdivision -PAW
ISL/Wp��,b,
City n)M,..Tc� Tct'J[ML-
yOCfft,.lK ZIP-4K,41er
Affected NCW ®EW
PTA �ES
❑FITS Adj. Wtr. Body
an/unk)
AEC(s):���' ❑OEA ❑IRA
❑uW ❑SPIMA
❑PWS Closest Maj. Wtr. Body
nt�1JrNU
ZfVO S OA)N )
ORWano PN :
es no
Type of Project/ Activ)ty 1"fCJna_
S�Ahne, kULA-
CC 10
r 61 j-1 6-a.Pj ' V V
ACLtsSe VIM 600 X Il) �(IIJI
fin b Pt Ilr-�oam
(Scale: NITS )
Shoreline Length 1112,
Access Length ppI yr 'si V
Pier (dock) length N� x 7t e
Fixed Platform(s) IQ'vf lht
Floating Platform(s) ✓
Finger piers)
Total Platform area
Groin length/# ^/
Bulkhead/ Riprap length I
Avg distance offshore
Breakwater/Sill
Max distance/length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing i
Other ✓
k-
SAV observed: yes Chwcr IJ� i `)Z ��
Moratorium: n/a yes fno 11 �ls�I fI VIvm tSite Photos: yes rWmNCj/H vtl?v'�
Riparian Waiver Attached: yes
A building permit/z,Qning permit maybe required by: W!�%�NSM-11 LU.
RULES
Z (teQo��Jft ID`xlut /
it11:12 /
V' Nk /
C�'KYgt 1
P% �aoAs�jJ
✓14uhU13
ND 1VP)VLjZ
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
Gr .F] See additional notes/conditions on back
1 Air I ---
STATEMENT. (Please Initial))`
Agent or lican[ ame Fermi racer s rKIN
A o 9yYLc L✓\
Si nature *'Please read compliance statement on back of permit-• Signat re /�' ��
1 z�c1,o Itoz- i; �I-2 - �a
Application Fee(s) !2 Money Order Issuing Date - Expiration Date
Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Berde, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946.6481
Fax: 252-948-0478
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:910-395-3964
(Serves: Brunswick, New Hanover and Fender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021
N9 84523
Previous permit
Date previous permit issued
A B OC D
i
"" [�(CAMA ❑DREDGE & FILL
GENERAL PERMIT 8'9'^``4*
_k
on
New ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized
�bby-tthe State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to: !"r I SA NCAC � N • 12-06 ❑ Rules attached. 9 General Permit Rules available at the following link: w .deq.nc.goy/CAMArules
Applicant Name l0rM1 FXFIG" U WUJ UL 1 OAW-P ICI LYA7lCV.
Address In S. .0 C �t!�
City JkiV ; SVLLLb'� State � _�ziP 0,6
Phone #( IV ) 0
Email Subdivision 4— ^A
City ItlA%x/til, pe�/+f�,H � zlP 28&12
Affected NcW ®EW PTA �ES ❑PTS Adj. War. Body 5T(oitr�r4�,/�tbWNL (� �naJtiman/unk)
AEC(s): ❑OEA ❑IHA ❑uW ❑SPIMA ❑PWS Closest Maj. War. Body 6IV'a'aA oJ017NV
Authorized Agent
Project Location (County)' N6LO De -
Address/State Road/Lot#(s) 51 �'1 LV1 EW DQ-
Type of Project/Activity N612 sC 4b t'Pnr-kUL} X �'��/ N 6-al /J'u ACL&SC VIM i 41JO A- )6�?d
Flut: ptnIrwiv% (Scale: N5<, )
Shoreline Length a
Access Length y'sl� v. V
Pier (dock) length N- Y S' 4� '�!
Fixed Platform(s) 1 n' �1 I &
Floating Platform(s)
!
Ip0,
Finger pier(s)
i
Total Platform area 1 f-F� {�'�•' �
Groin length/A �/ w x
Bulkhead/ Riprap length ! '!
Avg distance offshore
Max distance/ length /
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing i
Other
SAV observed:
Moratorium: n/a
Site Photos:
Riparian Waiver Attached
A building permit/zRning
Al
r
Ste- `p-►C7�
/ yX5/Pffa2 /
IV
1tyj ,. G
h'ka=s4
yes
,�
yes ,CI�LRIIQ �l Qi1L1�
yes *A
yes .1Nf(y�t y1
"IW ur`�
a yv )
permit may be required by: JV-�/(�-
Agent or Applicant PRINTED Name
t
Si nature **Please read compliance statement on back of permit**
Application Fee(s) 6heo^oney Order
WA
w �
� �tif�jJ
"114CA S
❑ TAR/PAM/NEUSE/BUFFER(circle one)
❑ See note on back regarding River Basin rules
.❑ See additional notes/conditions on back
(Please Initial)
Permi f(icer's PgRIN�TEgNpme�
Signat�•r�e!�,�I (�p— L,v(,��(�r`✓�a
Issuing Date Expiration Date
Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit conditions. Any violation of these terms may
subject the permittee to a fine or criminal or civil action; and may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for
compliance. The applicant certifies by signing this permit that: 1) prior to undertaking any activities authorized by this
permit, the applicant will confer with appropriate local authorities to confirm that this project is consistent with the
local land use plan and all local ordinances, and 2) a written statement from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules
for the River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the
NC Division of Water Resources. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax:910-395-3964
(Serves: Brunswick, New Hanover and Fender Counties)
Revised 6/01/2021
Weychert, Curtis R
From: Baird Kilpatrick <baird.kilpatrick@gmail.com>
Sent: Monday, November 22, 2021 8:55 PM
To: Weychert, Curtis R
Subject: [External] 51 Sailview Dr Boat Dock Information
Attachments: Screenshot_20211122-203846 Adobe Acrobatjpg
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hi Curt,
Please find attached boat dock information for the general CAMA permit we discussed today. The walkway is
approximately 4' wide x 85' long (340 sq ft). The dock is 10' x 10' (100 sq ft). If you need any further information please
let me know.
Thank you,
Baird
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NOTESSU-
', THIS RVEY IS OF AN EXISTING PARCEL OF LAND.
2. SUBJECT TO OF
NO ORDIS p0.�
RESTRICTIVE COVENANTS, I OP
EASEMENTS RECORD, 20NINANCE. & UNDERGROUND _IIf lEW
UTILITIES, IF
ANY NO TITLE SEARCH BY SURVEYOR.
4. REFERENCES; DB 5W8. PG 503; MS 3B, PG 221
5. FLOOD ZONE: AE 12 (EFFECTIVE 6 to LINE TABLE FRIS COMMUNITY PANEL P3720. Zc,
6. VERTICAL DATUM USED IS NAVD1888 K L7 S75tl-06'-39'E 32.20'
7. THIS PROPERTY IS LOCATED IN A COBS DATED 1 O/IM L2 S5Btl 30 WF53E 16.26'
8. ZONE: NORTH TOPSAIL BEACH CUFR L3831d-14•-GCE 29 Oq' \N�,
SETBACKS PER TOWN. FRONT- L4 S31O-WOU- E 20.11 PNEP
SETBACKS PER MB 39, PU 221; FRONT 30, SIDAR-1 R LS S25d 28 OPE
HEAR SETBACK ALONG STUMP SOUND PER DEED RESTRpONS)4a
0 HIS P TIS LOCATED 9 PROPOSED BUILDING HEIGHT -WITHIN
WATERS ZONE. q OUTSTANDING RESOURCE
V
11. FIELD DATA COMPILED 10-28-21. VICINITY YAp (M)
12. FIELD ON OF
WEYCHERTLOCAL CAMA OFFCLER' NOVEMBER 20211; GH WATER AS LOCATION OFBy T IMPERVIOUS -OHS
COASTAL WETLANDS APPROXIMATE.
�wL TOTAL LOT AREA (DEEDED) -20,00 SF (0.46AC)
PROPOSED H�+^"- 00 S51'03'41' TOTAL LOT AREA TO COASTAL WETLANDS). WArFR DR,LA 24.44'
6'MIM 1DO 10' yBY _ PROPOSED BUILDING-3.37B SF
II DOCK O•E 73.BT P CP CONCRETE DRIVEWAYAPRON W4SF
STUMP SOUND PERVIOUS CONCRETE DRIVEWAY. DST
34 v, '
CP Y 8 yIti ,p 'p7µ(µ'p µ µr CONCRETE P K O SF
y, y, • y�� 9 . TOTAL IMPERVIOUS COVERAGE ON LOT: 30A2 SF 23.1
7,µ ,p ,pY v, Yin-y'..Et1PN0 I J
�p „Y •Ap ,p PBTP1-,W+ti y / MAXIMUM IMPERVIOUS COVERAGE ALLOWED PER p0"p' µ' ,3 •p er/ DEED RESTRICTIONS 1467, PG 3W). 5,124 SF
CID ��I E41 LOT AREA WITHIN 575'CAMA SETBACK 17,1475F(0.39AC.
1 ALLOWABLE BOA WITH 575' SETBACK = 4,287 SF (25.")
1.71 '/ 9U0 ,4�771 BUAPROPOSED WITHIN 575'SETBACK= PROPOSED�� �/ %) /'1 STORMWATER 3.962 SF
4'DOCK. B4 LEL _. -.._ BERM PER DEED
rFooLor I _POOLDECKSHALL
BE WOOD OR TREX -LEGEND.
ILY 1 DECKING SIR - 1/2' Sel Iron Rod
z ( ( 1 EIP - Existing Iron Pip,
10.0' TOP OF POOL SHALL EIR Existing Iron Rod
$� FORS 1� NOT PROTRUDE MORE CID C,kulal,tl Point
( 14' q IF 7j3` T PROTRUDE
M CID Ca .tat" a
29 ` v Btu Ib AVERAGE GROUND 08 Deed Book y
MB-Map Book
'�+C1 PROPOSED ;. p 1 � PG � Page
Oe`,iG,`Y� �,-yEEO R00MY EDP - Existin Edge of
ZRESIOENCE W I FAR+No wWl A,PtQ, 50 PP- Existing P,werpolePavement
\ m1 PDIVER Ell ,I-P'`Y i MBL- Minimum Building Line
\ El S ` ��.,,- (123 �� // -Properly Line Surveyetl CONTROL CORNER \ / - - - - - - PI-P,rly Line Noten,, tl
N=27876B.01 "'�� F siaw+l ePo"� /
E=2482124.27 FRE01F /
UnnIVEWAYMggy /
\\6P0gpN PBorosEO FERvxXls PROPERTY INFORMATION:
„NCRFTE ORWEWAY
\ CONTROL CORNER OWNER. TOPSAIL BEACH LEGACY, LLC
N13.23'09'E� N=278674.10 ADDRESS:
26.85' El IR E=2482124.08 1650 HWY 50 SOUTH
\ \ / MAGNOLIA, NC 28453
PHYSICAL PROPERTY ADDRESS:
51 SAILVIEW DRIVE
CH=N47.21'21'W \ NORTH TOPSAIL BEACH NC 284W
25.02%R=50.0' 6' / AREA: 0.34 AC.
` ( REFERENCES: MB 39, PG 221
S05'27'26-E I DB 5568, PG W3
46.73'(T'IE) PIN #42870528281
SAILVIEW DRIVE
(RAY VARIES)
NORTH CAROLINA
ONSLOW COUNTY
L BRUTLYAI{ PROFEYIt POLNOAT L
1"3810E PLA
NUMBER
UMBER 7(_".I�AT IC SCA L1 I N I I.114%RY1151"0M N VIALDRAWNUNDER MRUAGMSURVMMro111Y
MADE UMDM WWPMWSIONDHMPOLGWNO
�x
IMFORMAWOM WAS UMEO TO PERFORM THE SURVEY, CLASS OF
SURVEY, AT POtR1pNAL ACCURACY, tl RW I TYPE OF py
FIELD PROCEDURE, VRSR"OMI DATOM, NADN •S=0 P118YMINApY PLOT PLM FON -
NAVDS 71UNDMOSSUROIDOHCpMDINED p�� ACTOR, BAIRD KILPATRICK
B•tpplSSTI uxm, ut tugvtY FEET, 34919Lfl14lLfLFTF
A.�Y� CARO`'W LOT 51 SECTION 1, CAPE ISLAND SUBDIVISION
pfE351 SAILVIEW DRIVE
- NORTH TOPSAIL BEACH MN =,aM
SEAL STUMP SOUND TOWNSHIP, MMW4AEM L-4aae tcuE,r=w ONSLOWCOUNTY,NC R�1"m
WESTON LYALLAPE PLS PLLC
WESTON LYALL t- 214 MIGMlY 17N SUM( E
REGISTRATION NUMBER L-443S �'YI.sr0N�`IPxAA HOLLY RIDGE, NO All
gnOU1LMNN PMOMp t100Ap4tt1 RAMLICtMtEN ,
STRUCTURAL 4 CIVIL ENGINEERING 4lANn ei i„mno,.
OPNi
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL. RFTIIRN RPI"CIDT
Cap *MQAmftrs comnu e Il;iic
Name ot'Adjaoent Itiparian Proper,y hecne,
Address
City, &ate zip
7o whom It May concern:
This correspondence is to notilj you aN a riparian plopelI\ mtIlei thal I aln appinnp Illy;t t :1\IA \linor permit to
P od_-- IU xio AAA.
waltul t� [wcxxt walVwae4�
qq�� S�
n my property al �I�V�Q,I•U _..... _..
(,hint\. X%iuL h r•'Idlaccnl II, �,nu pr,y,rrn. ;\ cope of the application and project drawing is attaciletUutclosed i'ar your rccic,v.
Iryou have no objections to tile: proposed ,rctivuc, plea.,• mall, the ,grproprialc ,l.ucn em bclm ;old Iennn to ran a. „um
uspossible. Iruoconmleolsare rcca•nal"idlillIli ,l;r.,,1lr„oipi<,IIhi,n,qi��.it,.illber�nl,ldcn'dihul1„ueit, o
conuuvntN or objections regardiur Ihi, pl ojeiq .
It Vol' have objections or cornnICIIN, pleas: ncn 1, the appl,q,u.uc .lalh<ao„ and ,end our conespoudcu,c uI.
(LOCAL PERMITOFFICTA, NAM I ()1 1,O( ,.menl
<,(rA'I K'.a11 I. yell[ 1N(, :1Ulntl.Js l'I I }, 57,11T. LII'
It�'Ivou brave any questions about Iw pmiecl, pb,,aek, not 11"itate to eonatcl meal Ins addre•N..number listed behm, or
criatact (LOCAL PERMIT OFI'I( I:R) al (I'I IUNIi vI: \Iltl R1, ur h} ell ulil at. tLP() I.tdAII i.
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LL rUvcu I u
Properly Owner,,%- me O C Cl_ 2ft . 2.(D(Y)
I,Icphunr '�.nn;ln i
Address
Zip
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- - Alllacent 1Zipari:ul tii: ualilt*
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Print or Type Namc
I`Iaoo,-,unl,ri
Address
1 �1•.
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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIFI7 nnnu RGTI 10KI or�rinr
drawing is attached/enclosed for your review.
T. , -
Property Owner
State
Wheat It May Concern:
Date
is correspondence is to notify you as a riparian property owner that I am appIving for a CA MA Minor permit to
n1A rY . -i ... 1 .. _ 1
on my property at
to --.1 u-alury County, which is adjacent to your property. A copy ol'the application and project
Ifyou have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
as possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
comments or objections regarding this project.
If you have objections or comments, please mark the appropriate statement below kind send your correspondence to:
( OCAL PERMIT OFFICER, NAME OF LOCAL GOVERNMEN"I', MAILING ADDRESS CITY, STATE, 'LIP CODE)
If you have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
a n[act (LOCAL PERMIT OFFICER) at (PHONE NUMBER). or by entail at: (LI'O F.MAIL).
Property Owner's
Address
_ q'IU� 2q0. Z(p1Yj
Telephone Number
Cil) State
I have no objection to the project described in this correspondence.
1 have objection(s) to the project described in this correspondence.
Adjacent Riparian Signature
Print or Type Name
Address Cite
Date
Telephone Number
State
Zip
Zip
Rev;sed July 2021
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Weychert, Curtis R
From: Baird Kilpatrick <baird.kilpatrick@gmail.com>
Sent: Monday, December 20, 2021 12:16 PM
To: Weychert, Curtis R; Gina Polanco
Subject: [External] Fwd: 51 Sailview Updated Preliminary Plot Plan
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hi Curt and Gina,
Please find attached an email response from Rita Thomas. They own lot 52 Sailview. They confirm receipt of the plot
plan. Hopefully, this email will suffice as evidence of good faith notification.
Thank you,
Baird
---------- Forwarded message ---------
From: Rita Thomas <rpthomas1953Ca1gmail.com>
Date: Mon, Dec 20, 2021, 11:29 AM
Subject: Re: 51 Sailview Updated Preliminary Plot Plan
To: Baird Kilpatrick <baird.kilpatrick(@gmail.com>
Yes, I received it.
On Mon, Dec 20, 2021 at 11:12 AM Baird Kilpatrick <baird.kilpatrickC@gmail.com> wrote:
Also, do you mind responding to this email that you have received a copy of the plot plan.
Thank you,
Baird
On Mon, Dec 20, 2021, 11:01 AM Baird Kilpatrick <baird.kiloatrickCa)gmail.com> wrote:
Hi Rita,
Hope you and Ed are well. We tried to mail you a plot plan for 51 Sailview Dr. Just want to be sure you received it. We
hope to be putting pilings in the ground in a copy of weeks.
See you soon,
Baird
N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERED
IZ_ {g Zp24
Fdwin T. d' F �a R 1hfmas Date
Name of Adjacent Riparian Property Owner
07
To Whom It May Concern:
This correspondence is to notify you as a riparian property owner that I am applying for a CAMA Minor permit to
to ,A _ .._.__ . . I .
my property at -51 Quay i)r
County, which is adjacent to your property. A copy of the application and project
awing is attached/enclosed for your review.
you have no objections to the proposed activity, please mark the appropriate statement below and return to me as soon
possible. If no comments are received within 10 days of receipt of this notice, it will be considered that you have no
mments or objections regarding this project.
have objections or comments, please mark the appropriate statement below and send your correspondence to:
kL PERMIT OFFICER, NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY, STATE, ZIP CODE)
have any questions about the project, please do not hesitate to contact me at my address/number listed below, or
t (LOCAL PERMIT OFFICER) at (PHONE NUMBER), or by email at: (LPO EMAIL).
Property Owner's N
Address City
qI0.2cro. 240Y)
Telephone Number
SlAte
I have no objection to the project described in this correspondence.
1 have objection(s) to the project described in this correspondence.
or Type Name
Address
City
Zip
Date
Pq3 - 3L10 -- 9, 3 =�lP
Telephone Number
State
Zip
Revised July 2021