85209_Russell Cook_20220421

CAMA I-I DREDGE & FILL
N° 85209 A C D
GENERAL PERMIT -,04,--405:a7 Previous permit i
2
Date previous permit issued .'
New I Modification n Complete Reissue n 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:
ISA NCAC • n Rules attached. n General Permit Rules available at the following link:www.degnc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s) "
Phone#(_) - -
Email Subdivision
City ZIP •
t
Affected I I CW n EW n PTA Fl ES n PTS Adj.Wtr.Body • (nat!man/unk)
AEC(s): n OEA n IHA UW In SPIMA n PWS Closest Maj.Wtr.Body '`',- '
ORW:yes/no PNA:yes/no
Type of Project/Activity •
(Scale: _,)
Shoreline Length • _
Access Length �__�__ _ - _ -_
Pier(dock)length I N
Fixed Platform(s) ) ! I
Floating Platform(s) I i 1
Finger pier(s) ! _.I_Aviir-, ,
,/"
_ { # --
Total Platform area _ o 4
Groin length/# .__. ( } I 1'' it ,,
{
Bulkhead/Riprap length - #_- _ .__...__-,._.
Avg distance offshore = .. - — }-.-
Breakwater/Sill - ji4 �`� ^I ,:... •' -` 1,.
j i - i i +Ce t�` y ' i
Max distance/length � i 4 I
Basin,channel I I t 4
Cubic yards i ff •
.....- - -.._ —-1 - - j
i t)
{
Boat ramp �_- �� , L� � r I I �
Boathouse/Boatlift . ! f ( `�COO ,
Beach Bulldozing i ; _- - i . / I'�
Other _ Tj �. y ;_....... " r 1
i
i
SAV observed: yes no I'
a •
Moratorium: n/a yes no .,-
Site Photos: yes no r r A�' {
Riparian Waiver Attached: yes no • I IJ _
- ti
A building permit/zoning permit may be required by: '
Permit Conditions El
TAR/PAM/NEUSE/BUFFER(circle one)
See note on back regarding River Basin rules
nSee additional notes/conditions on back
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) -
Agent or-Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
Application Fee(s) Check#/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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext. Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie, Camden,Chowan,Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

' ` CAMA DREDGE & FILL ` ! d 85209 A B c D
—1- D # �J6
I Previous permit
l? GENERAL PERMIT
2 Date previous permit issued
New I I Modification I I Complete Reissue I I 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 Rules attached. I I General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s)
Phone#( )
Email Subdivision
City ZIP
Affected CW EW I I PTA I-I ES PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): I I OEA IHA I I UW I I SPIMA n PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale: )
Shoreline Length
Access Length _-!_—_ --.-.---�__ -,_........-.--[-. I I.
.4r-* I j . . i -.f..
Pier(dock)length } it
Fixed Platform(s) I ! i
.... -�
4 I { -- l i
Floating Platform(s) I I i
_ - —
i• �- j i
Finger pier(s) I
Total Platform area - .
i l
Groin length/# i __ '
Bulkhead/Riprap length __.__._- ---t-- �_.-....... '--- _ )_ _
Avg distance offshore I
Breakwater/Sill 1
Max distance/length {
Basin,channel
Cubic yards
•
Boat ramp , -I-- 1
Boathouse Boatlift I S !
Beach Bulldozing 1E .' I
Other '
E
SAV observed: yes no 1 i 1
Moratorium: n/a yes no I - i - ,
Site Photos: yes no , 'J ' , ' { < i F
Riparian Waiver Attached: yes no j I . I I ( , i
A building permit/zoning permit may be required by:
TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions
II See note on back regarding River Basin rules
See additional notes/conditions on back
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
Application Fee(s) Check#/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 Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret,Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext. Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie, Camden,Chowan, Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

Receipts for
Certified Mail
_ r.. /pa o / /, oz2 (Staple Here)
Da e
'`)oWA! Coo/hB$
Adjace t Pr pe Owner
Mailingg Address
rJ.C!<r.'JT.4 L1?cf7/
City,State,Zip Code
Dear Adjacent Property: Q
This letter is to inform you that I, p`GSSEL L e 414— have applied for a CAMA Minor
J Property Owner
Permit on my property al /-3% t1A' 1-4f4L A PI( PA/61 4 i- A/, C, ,in COUNTY
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s)as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form.If you have any questions or comments about my proposed project,please
contact me at IV— Z-.--/-07_57 ,or by mail al the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY, STATE, ZIP CODE
Sincer
.mil 2
Property Owner
/-JL fig,04 ' &A a.
Mailing Address
Ord/F_A1TyL N d ar`1i5-7/
City,State,Zip Code

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to /t�lJ flu CD��� 's
(Name of Property Owner)
property located at /3 / t 2Nib K L A uv ,.
Address, Lot, Block,Road, etc.)
on OA-L ig4— CA?IEI 1 , in 0,/F,-'722 L , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Ct ---
Signature
Print or Type Name
29-2--- 2 4 -- l Z(-1`
Telephone Number
5 )4►�2 ZoVZ--
Date

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SITE DRAWING/APPLICATION CHECKLIST
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••m Sua.mer'AsulAs APPLICATION FOR
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` 1:NI irylaa)e eiitee-saass yy��7��]cy n}� 'p�CAMA MINOR
r` _ -I .I r:.dane:khlh 1VE Y ELOS 111LN 1L
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Coo Mid ManaClfaent
Li,4'i$aconv::IhJy fhY.am:Nlhrif QUALITY
•an sl(M.I'll Ut\f'11:1I1]I IC S PERMIT
✓ Dths.riddialtrnnolICA'solcPxttsthetIPD(iv ier:.t:co Io1974.she North Carolina Gnnn.lAstmLI)paned the tantal.te..il.ea mntct
_-Uss lerkithiofe:roi!:s sure:Fdzm (CAM)ovJ set throne.for guiding dhalopm,et In(mile and pmdotis a anis that
If tiv sill ln.trnte;,.i th wvitva:Jz-ts !seder the male"snood.sod ocesnfeanl.Store bilk requiring snub,care by;bnse oho
Dos and 4:cl J:._ri•-:.b'*te le.p_t.!narar.t haild and deselap.the Genen tAmmhte dinned the Coastal tI.•oum..Commi,Io
,,lj' Dr,.n;,1Ii Iltw:A-a (ctICIto implement clear reentatbas thannlnimlre the burden on the appfmnt.
� l • IJ:Xteni)I.LAua l:a off( iatya;i:m losmsI l III fe:z»obLan
Dad xml lend em:m r,.c i r c ticco a:e t PO teraste�:Cl 1 his application fora.Mnaur dtdipmeugbrmit wider(AMA I.part clan
_ DIs,sal kithi Is ea•a-t=r`'es:feassiry-y.,�g femmlolabl Ulan vs taut the pirit and intent of the General Assemble.II hes Nun
dN.ned to be sitAthllenerrd nod INUIT(uo mete lime or effort thin onr.vq from
li).until It:non Uwh apt L ojritn:a a the applicant.Please go ma tit foldtrmin tia that al Perms Officer ll.PO)for the
hhna don ovloscd:r.2zteia rf Iv:;rna+Jd:ena:;w:e px.lits in htthson plan to NM to be cask Hut son badeatand shot Information be
tI�_ Raw tall_W11'rtura iixat3.\IC' eat she need.before sou auk.
14 Rat r4ttti nil nc,J 1:n:.Iro:oat ITO tear ms..•_:I
R.m rShts;ltM 3"•da.hFft hit: I wit CAI t regulate..the minor permit in to be Issued bithia 25da)s once a
DATLOPAIE>r PLANS complete application is In htnd.Ot.n lea With I.needed If the pill..le dmple.lte
piocen cereratt tat.uhotn IS da).Volt can spud the appranl proems to mrlinp
-__Malt she Lk16;PlerihCJ nsbctm:Th, taruin that)our implication is completeand signed.that)one dranlog meth the
L':ae r9 rl¢I ertas tkJ v.dlhJ:y:hJ:::L'..e Lax,•^�J qud(Iutioes Olen inside and that application he is attached.
yam..Sae ca'nI1'Ihn rN J.^atopp!xnJ ttn.:OJ
LI 'J_` D:des-J ld:1 Iu:..vs I..i_IvncJ n:_+a2:J Met p.r mitt on,,mttime.trotted fa de.elapmet in ttecae.W arm bite then
saa zt cm miedr:crbJ are can CAS-nlated.se riot sun m ace':nilh the!scat Permit OR m lea drtumde
• with ofthee sou ma)weed.A list is included on page moor this ladder.
sO It 10.IPP•LICV]T
t n r pur
r cwperanen with theOath(Smlim Caakt elanatimm m
Ise en and souour sink:ots to pond in a so,That prolate men
aces mov done e hramif,) m
ol nod
...:x::tea tall btazlt_•ai l advYJ ifmr a;oketht,_, ptata.wnt,need.
• icJ J a.r.1 I e:t )J.ccn rerilh t s:.ua`
•itie ki so:thine k i;1;r Coastal Roomers Commission
• mt_I]ib::int r)pi:uainaf Dislsloo°renasml'Stoneware`r:I.cjtneCll.fucqthe
th
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:rb:r.Cr:ct nett..Jr Local I'crmit D:IS,^.[Ivin•:c n:.vm1ian
'NEItOI.INFORM VI ION SEE/E.\ILV'Or OWNERSHIP:
ND O'NLlt•St%LING ADDRESS { I iL: -L I -u of C\MAr < - 1pr thri r.-ru tlrref r YI n ro( .l
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Sv:.• - t+;_.__.IYw:.0 ._ SO16ir.c ION Ofl.!ti SC ea-RIPARIAN i PROPERI1 OD
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Receipts for
Certified Mail
(Staple Here)
AK"C
D/ /zca -
Date
-5-4Ni5 5 Co&3
Adjacent PropertyOwner
I S� P� /NSuLA O/G
118
2
7 'r4 N6 02
63_7/
City,State,Zip Code
Dear Adjacent Property: ,/�
This letter is to inform you that I, /� vss Cook- have applied for a CAMA Minor
Property Owner
Permit on my property at /31/ P6iv//t 54t'Li4 ODZ,�I��F �4 Nc' ,in COUNTY
Property Address
County. As required by CAMA regulations,I have enclosed a copy of my permit application and project
drawing(s)as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project,please
contact me at 5-7/-a"2'/—D 5-7 ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY,STATE,ZIP CODE
Sincere
w ��
Property 0 ner
/39 Pam,-/N5WCA it-
Mailing Address
OQ/F Wt at57/
City,State,Zip Code

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to /24"$5 4' eo&ie--- 's
/� (Name of Property Owner)
property located at /39 /tN��S4G D/L ieleitrAG /TI, C.
Address, Lot, Block, Road,etc.)
on o tiu142D C,eFF/L , in ta(e itN-54-L , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s),the development
he is proposing at that location,and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
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SITE DRAWING/APPLICATION CHECKLIST
'icasemzLes=your sitdmnmeirwlud.st efommia infmnmrim regard ImuCA\tAmirnr Rescindment pamiI
le Local Permit(Mica mill help you.ifrtiaetd.
• APPLICATION FOR j
'RCSICAL DIMENSIONS I a
Label roads CAMA MINOR
{fLabel highnays rishi-ofma)s
_Lbaeomas all suhimn DEVELOPMENT
libell local ue ums mdd mmaysmm�ah edging m)amtrh
Label adjacent ommhdy Coastal Management
ENVIRONMENTAL QUALITY PERMIT
'ill'hiC,\L('INIL\CI"ERISTICS
Draeard label romnl high mntn bite(cmtxt LW for assistance) In 1974.the North Carolina General Assembly-passed the CnsstalAna flanegement Act
Deno legation of on-site stasis-water swam
(CAILl)and sit!besiege faronidif dnebpmeat in fragile lad pmdmn bane,that
Ifsmmillbemmkivgmda oa-arrhwuNara bonder the states sounds and oteanf L Almadith requiring special care by that mho
1 -Umva&la0.gdune rid build and develop.the Central:assemb directed the Coastal HERMITIC.Carom/Won
gslrrciudc spat element) P
f1/41
Ihammdla0sq the ofdma (CRC)W implement clear regulations that minimize the harden on theapplicant
Identify and lope frst liar ofsablesegetmion(tomato LPO fro assistance)
Draw noel labelecmiansydsal line(most CPO foe asin ) 'Ibis application for a minor do dopuma.permit under CA'lAv part of the
-Draw and label tole iapticet features(optional) Commissions effort to meet the sprit and intent of the Gtuen6lnemldy.It has been
designed to be srn ghtfonsad and require no more time ore line Than tetnvey from
If sou be mating in aenawl shadix arcs the applicant.Please go over Ibis folder with the Local Permit OfererltPO)for the
• Stop the icier overhang asa dried linearomd the structure totality yi in obit's yin plan to bold to be certain that you undmtaed n hat information he re
s IiDrae and label truisms]limit ofAEC or she needs before son epps.
_Dram and label all sea:3.1 lens(coat•t LIY)Prasais m:el
Draw and label tie)O.fo.d buffo lino Inver C.\lLlmgavRons.the minor =
permit Is lobe ts,v&wiWw isday orate. -5
IES'ELOP\IENT PLIAS towline application is to band.Often In,rime is needed ifthe project is,imple.tht
process general's tales about 18 da)s.Tou mu speed the enamel process by maidia
_Mao and label all proposed structures certain that sour application1v complete and signed.that sour drovim:meets the
Draw end label areas that will ledismrbeda¢Yor landscaped specifications eh en inside and that searapplimtiao the attached
.ate sae of piling and depth to be pawl ingrate-al
8 Draw ad Whelan areas lobe pased or SmsehJ Other pennies are mroeWu n regvlrtJfor @nbpmenllalbe e.aslalam.Wblte these_
Sinn MI area mbedsmhJ an not GUN-dated me nsee sou to clink with the Local Permit Officer to detenuier
_Shot lands:aping which of these no may ord..%list is included on page two of this folder.
COIETOAPPLICANT
We appreciate your cooperation sdtb the protectsr Carolinasocnn of
Progreso
Imt)w and soar.mingan,m bid in a nay that We moenn of ourbnnlifnl end
n tf h'd n all Ls omd'a coda:&ifn of applicable.' potlatch toast.
rtxti fed ed and listed adjacent proprts mnous?
imlad d)umsce drassing? Coastal Rnonrcn Commission
dgxd and dated We application? Disision of Coastal Management
enclosed the SIM fit f+ea
cnmide:0 arAEC Hazard Nome.if necessary'(Man le silted by the propatyonnca) y
FORSTAFFI SE S n a
dirt Notice Posted - Final Inspection_.Fcc Remised. — r i
m �r 1
inet 7
p man n
El
)arc otAMha Issued Esemp& _._ Denied _Appeal Deadline(20 days from Rama action) nest from fnws).Wi!an not u
•
•
•

:Alit) Permit Number OTHER PERMITS\LIT REREQI'1RED Ilx ant ity gnu arep'awmg may require permits What than the CAShA
miner de:elvpaw^n remit.ineluinr_.h Irex lathed to:Drinking Water WolLSeptic Tank(m Wha saniaty taste
can Hsmd_Estuarine Shoreline_ORW Shoreline�Public Twat Shoreline_Other_ oeanmrvssttaml,Building,.Eleasiml.Plumbing.llcutirn and Air CondiuortR.Insulation and Energy Cowenanon Flit
(Fatal/nit'we DO) Certification.Sand Dune.Sediment Co ol.Srbdisirntt.Sppatal.Mobile Home Park Agnosal,llighnay Contraction.and
others Chock rids yew Local Permit Wins rig more information
'VEILS,ISFORMATION
STATEMENT OF OWSERSIIIP:
\D OWNER-SLSILLIISC,ADDRESS r1 //// Lth undersigned.anapplicunt for a CAMA minor deselnpment permit being mthce the antler ofprgmty in an AEC or
me Q.t&SEL. tun/ _ person a tt fired to act as an agau for proposes ofappil ing our a CAShA minor On elopmem permit.certify that the person
�L�/ ,� listed as laMotneron this application Ins asipturant interest in the teal MMenydsmbed thereat lies interest on be
deco /J% fl/"/N so e_ A 12L. described as(check one)
y-GR/G_NTr4LState N!r p ax S7/- n/—o7S7'%muter 1�1r1y1a rdebtessedintomm/aeor9 ,v U pen knwi C crL• KGM
see Deed Book rY'l paeZ-LL•� n the M1M1'ttech Caemn'Registry"r Dods
sad J
ontxrfy si
tf11ORIZED AGENT f _sr rtoe attic/genet ftpJu n ican heir to the estate of
N I// /^ probate rain Courts:
_if ogler ar ereat such co tartar comma orleae.explain Sdots or use asepaate Rita A attach to this app!ksriva
dress
SMo lap Poore SOTIFICAI ION Ot'Al1ACE.\T RIPARIAN PROPERTY OWNERS:
I fmthennre certify that the fmllaning petalsarc orsars ofpropenin aijoining thisproprp l allitm that I hove glum
WI ACR'.M.SOTICE to each of them concerning my intent to derrluptftu proper*and to apply far a DASIA pant
:CATION OFPROJELT(Addrens•xru M t n:meobrdmeix rs to site.nam ces e of the IN 1 IAdda+:
II) a r.F' co Be /S� P44-A-1 A) ne., net
/311 P eNI.A/sutA oA• — $1:A7.EA7 SS IT) 014 oats /'EN/Le.)rect a AC_
I-- ONr Sig I1/6N7PIt7 R. D/ic/r,94,9 6/�F'/G „i
/ Q pd✓ppN/a�SKLA
reposedSCRIPIIOS OFPROJECT:(List all reposedat trnbn veil dinmhnce I ACKNOWLEDGEMENTS:
I I Lte udns,id.xknWdedtethat We Ong ouuaisassare that the .kse:c anted for an area thich
T/✓s7's9LL 447P40)4 70 rTCAA."1" //Y/P 2'sP tse pltMe to aro.ionmLL'or fm4:lakn.nlds that to Leal Permit=eathas planned
to roe thepwv
d�A 5H O/f1/AJ ,� Ippr.ktJ problems associated nith this lot lids esplanatiott stai axomimtid by rccnrrmerdatian amuminsaabilira-
!EOFLOTIPARCEL J square for ♦a suet lac sal Booprmhng technigtxs.
OPOSED USE:Residentiel Lai (Single'famdy0 Multi-family 0) CommrcvPlneusnial 0 Other ❑ IhmMmresmil that l am au:oeircd to gin aid do in fact grant permission to Bitismno(Coastal Manageen suit
the Local Permit OR car and their agents to eater on the aforementioned lands in connection with esoluming infatuation
IaIPLEIE EITHER II)Olt(21 BELOW(Ceneoa.nar Local Await Officer flyem an not saen'lrhAECap es ratted to Om it application
.An ffleferD'): {�'/'�� �I
OCEAN HAZARD Ares:T OTAE FLOOR AREA OF PROPOSED SRUCIERF ) ii.rermgimludn / L�—
am lhianr SST my of�kkfa.Vbo,�t
coalitional liking spire.parking el matud:tosc pouts level,na-eanditioned space odow ground loud /eee���/,
_..----
:India?,mn:oad-hearing attic space) 1 Monrcrm prRSn amM1Wtnd roar ash
of'IilingaCrl.\4Spmnitappli2tint
CO.SSTALSIIO I ." cite SIZEOt'UUIIDING FOOIPRINI'AROOMIf.R ISIPERTIUUSORBUILT Tbb ayplimtkoirriuJrcgerxnJ i ion irre r oofilerGmrm_q atdesmf JmrhekrMolaila application Jr
OSSURfAC[S fMlineldrn4amofthe ramdadon of all WiWimcdrin pairs.wsr:d decks,
oxamhpsavemew.the Ocean Ireton!.lECNoiie.adare rmeua0.a check far MMMRM aide payable Co the!natty.oaf
rate or ransom, to dui are ssithin theappli_tteAEC Mach>ourcalcuIdiorn nirhtheper Tdraninpl rrorrur ururM Males! the mw]MdrrmDa rl nmgn.wdearnhJb rhrarwtmran
aW"t!a Pas (k by rp( f xappll J'
ATE SrORSOEtTERSLUACEMEST PERMIT:Is at props-floated in an cncobject toaSme icc+rWmrnluitlmarrrlenore b mypeanr xhffiroar b itmal.Doman,frm Jere&tails nil)convince o aommrn of
worsr\fana Permit/tatted by tit NC On Won of Energy.Mineral and Lard(UEMERI' commit AmTerson derelepiri oson.1ECneslinepermit is sabler,to rant criminal ea almiaitmarre anion
S_ NO_
�{
r.little totlh h upon mea'impenimo sodden.horsed for gent lot or/trcet� sgve feet