85449D - Garcia

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GENERAL PERMIT
I NeW . flodification Con:piece ReISSA Nroal Reissue
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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: Lrj IM0 5 �t, 1,1,1 ./ r-c( ��
Address of Property: Sy r] 5 2
. , �C'Cc C�.��j i9 k.�51Ct HC �S (c,5
Mailing Address of Owner: r>/-9() ( 1� �', fj !�l ���(„5
Owner's email:e.Oef ftti�t>t5/(-61 �Q� Owner's Phone#: �j�,2�— �50 —(e3 55
.JJJ 11 ry,a41 ,CCYO
Agent's Name: g Agent Phone#:
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
I hereby certify that I own property adjacent to the above referenced property.The individual applying for this
permit has described to me, as shown on the attached drawing, the development they are proposing. A
description or drawing, with dimensions, must be provided with this letter.
I DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management(DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 127 Cardinal Drive Ext., Wilmington, NC 28405-3845. DCM representatives can also be
contacted at(910) 796-7215. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
I understand that any proposed 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
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive some/all of the 15'setback
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: A ZN t� G�
P(�'''�.
Typed/Printed name of ARPO: 11 C:k y• ,t'
Mailing Address of ARPO: 3 3 L_tA w i yt c{ r %c'111 - V If' \�r cc rkt N C
ARPO's email: N l 1} ARPO's Phone#: cl 0 oo cc>
Date: 1 ) 3) f�p *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

Zoho Sign Document ID:MYBAWBJ76CFRW8-UHIRZA3TI7ZYMHOKMOYCBH6NCQEQ
ADJACENT RIPARIAN PROPERTY OWNER
NOTIFICATION/WAIVER STATEMENT IN COMPLIANCE
WITH CAMA REGULATION 15A NCAC 7J.0204(b)(5)
Pursuant to the North Carolina Division of Coast Management, including but not limited to the
Adjacent Riparian Property Owner Notification/Waiver requirement, by signing below I agree
that, effective January 14, 2022: (1) I am a property owner on West Beach in Oak Island, NC and
am seeking a permit to push sand in the January/February 2022 timeframe and have applied for a
permit with DCM to do same; and/or(2) I am on notice of one or both adjacent riparian property
owner(s) seeking to obtain a permit to push sand in the January/February 2022 timeframe; I
understand the scope of the permit request and work to be done; and I have no objection to this
proposal or work being done. The effective date of this document is January 18, 2022.
1- Q -t ZZZ
Skip Smart
6335 West Beach Drive
Bill Hancock
6341 West Beach Drive
�Gt gr ei
Mark Engel
6601 West Beach Drive
Adjacent Riparian Property Owner
Notification/Waiver Statement
West Beach Properties
1

Zoho Sign Document ID:MYBAWBJ76CFRW8-UHIRZA3TI7ZYMHOKMOYCBH6NCQEQ
John Stewart
6605 West Beach Drive
� -y-
Nancy McMurray
6607 West Beach Drive
644
Ashley Harbin
6609 West Beach Drive
(�kk.CAviRe 1 Lv< vg
Cathy Lovejoy (LCI Properties)
6613 West Beach Drive
J�9 ry �
Barry/Shari Golob
6615 West Beach Drive
ftj—C14
Mark Davenport
6617 West Beach Drive
1CAY\. .c,
Bianca Briola
6621 West Beach Drive
Adjacent Riparian Property Owner
Notification/Waiver Statement
West Beach Properties
2

Zoho Sign Document ID:MYBAWBJ76CFRW8-UHIRZA3TI7ZYMHOKMOYCBH6NCQEQ
Mike Ouimet
6623 West Beach Drive
Jeff Powell
6701 West Beach Drive
Bob Bomholt
6703 West Beach Drive
-11OYh.GS �GrGiG
Thomas Garcia
6705 West Beach Drive
Barry/Seena Gudelsky
6713 West Beach Drive
Morty Sjoquist
6715 West Beach Drive
e y- 6 7(q
Kelly Coy
Adjacent Riparian Property Owner
Notification/Waiver Statement
West Beach Properties
3

Zoho Sign Document ID:MYBAWBJ76CFRW8-UHIRZA3TI7ZYMHOKMOYCBH6NCQEQ
6719 West Beach Drive
Mary Ann Cost
6721 West Beach Drive
4,-*,„,r D. 4
Arthur Anastopoulos
6901 West Beach Drive
Cam- 0
Chip Oury
6903 West Beach Drive
Robert Hurst
6909 West Beach Drive
Adjacent Riparian Property Owner
Notification/Waiver Statement
West Beach Properties
4

Check
ad Deb Deposited I Check Fram(Name) Neme d Permit Holder Vendor Cheek number amount Pamrk Number/Comments Reeelot or Refund/Reallocated
Coiumn2 Column3 Column/ Colunn5 Column!! Column? Column➢ Column➢
122 ;Land to Sea Construction,LLC Joseph Ballard First Citizens Bank 564 $ 400.00 GP#85589D JD rct.16561
122 Land to Sea Construction,LLC Caroline Rudolph First Citizens Bank 565 $ 400.00 GP#85588D JD rct.16562
122 Terracon i Duke Energy Bank of America 2292691$ 400.00 GP#85498D BH rct.15999
122 Allied Marine Contractors,LLC Blanchard&Wells First Citizens Bank 10822 $ 200.00 GP#85558D JD rct.16560
122 'William Robert Taylor Ill same South State Bank 9025 $ 200.00 GP#85590D AW rct.14882
122 Tongue&Groove,LLC Bob Fleury Suntrust Bank I 13492 $ 600.00 GP#854020 BH rct.16258
122 i Grice Construction Ed Read Twist 10864 $ 400.00 lGP#85451 D PA rct.16543
)22 Thomas Garcia same Delta Community CU 2278 $ 400.00 GP#85449D IPA rct.16501
)22 i Cohen Construction,Inc.(1 of 2) Robert Cohen Uwharrie Bank 1 21698 $ 100.00 GP#85452D PA rct.15673
)22! Cohen Construction,Inc.(2 of 2) Robert Cohen Uwharrie Bank 21618 $_100.00 1GP#854520 PA rct.15673
)22 South Cape Maritime,LLC (Terry Wyckoff Wells Fargo 1146 $ 200.00 I GP#85404D BM rct.16259