64-15 Minor Mod Cape Carteret Baptist & Presbyterian Churches

TION/MINOR
Permit Class
MODIFICA
' STATE OF NORTH CAROLINA
Department of Environmental Quality
and
Coastal Resources Commission
Permit
for
X Major Development in an Area of Environmental Concern
pursuant to NCGS 113A-118
X Excavation and/or filling pursuant to NCGS 113-229
Permit Number
64-15
.4
-Issued to Cape Carteret Baptist and Presbyterian Churches 101 Anita Forte Dr / 100 Yaupon Dr Cape Carteret NC 28584
Authorizing development in Carteret County at 101 Anita Forte Drive, and 100 Yaupon
Drive, Cape Carteret as requested in the permittee's letter dated 4/18/16, including attached
'.workplan drawings (2) 1 dated 4/18/16 and 1 dated received at DCM Morehead City 515116
This permit, issued on June 6, 2016 is subject to compliance with the application (where consistent
with the permit), all applicable regulations, special conditions and notes set forth below. Any violation of these terms may
be subject to fines, imprisonment or civil action; or may cause the permit to be null and void.
1) Unless specifically altered herein, this Minor Modification authorizes the filling and grading of a
70'x90' (6,300 total sf area) area in a non -coastal wetland area on the northeast corner of the lower
pond north of the Presbyterian church and west of Yaupon Drive, all as expressly and specifically set
forth in the attached letter and workplan drawing. Any additional land disturbing activities and/or
construction may require a modification of this permit.
2) This Minor Modification shall be attached to the original Permit No. 64-15, which was issued on
6/1/15, and copies of both documents must be readily available on site when Division personnel
inspect the project for compliance.
3) All conditions and stipulations of the active permit remain in force under this Minor Modification,
unless specifically altered herein.
(See attached sheet for Additional Conditions)
This permit action may be appealed by the permittee or
other qualified persons within twenty (20) days of the issuing
date.
g This permit must be accessible on -site to Department
personnel when the project is inspected for compliance.
Any maintenance work or project modification not covered
hereunder requires further Division approval.
All work must cease when the permit expires on
? ` December 31, 2018
In issuing this permit, the State of North Carolina agrees
that your project is consistent with the North Carolina Coastal
_ Management Program.
Signed by the authority of the Secretary of DEQ and the
Chairman of the Coastal Resources Commission.
y Braxt& ° . Davis, Director
Division of Coastal Management
This permit and its conditions are hereby accepted.
Signature of Permittee

r
Cape Carteret Baptist and Presbyterian Churches
�a .
ADDITIONAL CONDITIONS
Permit No. 64-15
Page 2 of 2
'NOTE: The U.S. Army Corps of Engineers assigned the project COE Action Id. No. SAW-2015-00895.
NOTE: The N.C. Division of Water Resources assigned the project DWR 420150318.
r' 1

PAT MCCRORY
Coastal Management
ENVIRONMENTAL OUALITV
DATE: MAY 5, 2016
TO WHOM IT MAY CONCERN
Cc: COURTNEY SPEARS, Asst. Major Permiit�/
Permits Coordinator
FROM: HEATHER M. STYRON, Field Rep`Y�1t-�
DONALD R. VAN DER VAART
1-I' l "
BRAXTON DAVIS
Uuro„r
THROUGH: ROY BROWNLOW, District Manager (EV
SUBJECT: STATE PERMIT NO.64-15 MINOR MODIFICATION
NCCF and Cape Carteret Churches' Wetland Restoration Project
By copy of this memo, DCM is requesting that you provide any comment your agency may have on
the proposed project to Courtney Spears, Asst Major Permits Coordinator for DCM.
Please send any comments your agency may have to Courtney Spears at the DCM Morehead City
Headquarters office within 10 days of the receipt of this memo.
Please find correspondence enclosed dated 04/18/2016 from Kris Bass, requesting a permit modification.
State Permit No. 64-15 was issued on 06/01/2015 for the construction of an infiltration wetland and a salt
marsh wetland from two on-line ponds contiguous with Deer Creek and Bogue Sound, Carteret County.
The permit expires on December 31, 2018.
The applicant is requesting to fill and grade a 70' x 90' (6,300 total sf area) with approximately 50' x 70'
(3,500 sf) impact to a non -coastal wetland area on the northeast comer of the lower pond. This area is in
the eastern pond north of the Presbyterian Church and west of Yaupon Drive, immediately south of the NC
Hwy 24 DOT Rights -of -way.
A check (#1597), received on 05/05/2016, in the amount of $100 has been received in order to process the
request.
Please contact me at the Morehead City District office if you have any questions.
Nothing Compares_:
State of North Carolina I Environmental Quality I Coastal Management
400 Commerce Ave I Morehead City, NC 28557
252 808 2808 T

Kris Bass Engineering, PLLC
625 S Lakeside Dr.
Raleigh, NC 27606
Office: 919.960.1552
Email: kbass(d)kbeng.org
April 18, 2016
Roy Brownlow
NCDCM
400 Commerce Ave.
Morehead City, NC 28557
Re: Permit Number 64-15
Cape Carteret Stormwater Ponds Retrofit
Request for Modificaton
Dear Mr. Brownlow,
Thank you for meeting with us on -site and assisting us as we work to complete this innovative
restoration project. As discussed, we are proposing an adjustment to the grading of the marsh
restoration in the lower pond (at the Presbyterian Church). We would like to fill a small area of
the pond that is quite close to Highway 24. This area has a very steep slope leading down to the
pond, and now that we have begun grading activities, the instability of the slope is apparent. We
are proposing to soften the slope away from the road and sidewalk, and match the existing
elevations on both sides. The grading change will help improve the safety of the sidewalk and
improve access around the site for maintenance equipment. The revised grading will require a
small wetland impact that was not in our original proposal. Because our project is a restoration,
we will attempt to minimize the total by adjusting the slopes to provide the most marsh possible
on the site. The maximum amount of wetland impact will be 3,500 square feet.
I am including a revised grading plan and a profile of a proposed modification of the site plan for
your review and circulation. Please let me know if there are any questions.
Thank you,
Kris Bass
RECEIVED
MAY 05 2016
DCM- MHD CITY

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
NC Coastal Federation and Cape Carteret Presbyterian Church
Address of Property: 100 Yaupon Dr, Cape Carteret, NC 28584
(Lot or Street #, Street or Road, City & County)
Applicant phone#: [phone] Mailing Address: 3609 NC 24
Newport NC 28750
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 have no objections to this proposal. I have objections to this proposal.
if you have objections to what is being proposed, you mustnotify the Division of Coastal Management
(DCM) In writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangement.nebcontact dcm.htm or by calling 1.8884RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to
waive the setback; you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Properly Owner Information)
Sighaimi
NC Coastal Federation
Print or Type Name
3609 NC 24
Mailing Address
Newport, NC 28750
City/State/Zip
252.393.8185
Telephone Number
4/18/16
Date
N:z
erty O ner Information)
Signulure
Print or Type Name
f
lOZ 12,o44 n
Mailing Address
Coy/Sta elZip
azrl -3 `I3 - 747991
Telephone Number
40t1z-s 214000
Duce

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMlAIVER FORM
Name of Property Owner: NC Coastal Federation and Cape Carteret Presbyterian Church
Address of Property: 100 Yaupon Dr, Cape Carteret, NC 28584
(Lot or Street #, Street or Road, City & County)
Applicant phone #:
252.393.8185
Mailing Address: 3609 NC 24
Newport, NC 28750
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. wAh dimensions, m6st be provided with this letter.
I have no objections to this proposal. 1 have objections to this proposal.
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. Contact information for DCM offices is
available at www.nccoastalmangementnef/contact dcm.htm or by calling 1-8884RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to
waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback
(Prope y Owner Information)
Sighature
NC Coastal Federation
Print or Type Name
3609 NC 24
Mailing Address
Newport, NC 28750
City/State2ip
252.393.8185
Telephone Number
4/18/16
Date
Owner Information)
Signalure
Print or Type Name
Mailing Address
d/Et� c%d fli/ Z t3 3 7—�
City/Sta-
71 Z 2-Z3 y��/
Telephone Number
Dore

Spears, Courtney
From:
Steenhuis, Joanne
Sent:
Friday, June 03, 2016 2:42 PM
To:
Hair, Sarah E SAW; Spears, Courtney
Cc:
Gregson, Jim; Higgins, Karen
Subject:
Cape Carteret Churches DWR # 150318
Attachments:
cape carteret churches mod.pdf
Courtney,
The DWR has no issues with the modification for the slope adjustment for the project. The Division will incorporate the
modification into the files.
Thankyou!
Joanne Steenhuis
Senior Environmental Specialist
Wilmington Regional Office
127 Cardinal Drive Ext.
Wilmington, NC 28405
Direct phone [phone]
JolnncStccnhnis(d ncdcnr.gov
**E-mail correspondence to and from this address may be subject to the
North Carolina Public Records Law and may be disclosed to third parties **

Spears, Courtney
From:
Hair, Sarah E SAW <[e-mail]>
Sent:
Friday, May 27, 2016 11:07 AM
To:
Spears, Courtney
Cc:
Styron, Heather M.
Subject:
Cape Carteret Churches NWP 27 project
Courtney and Heather,
I have no issues with the proposed modification for this project.
Corps AID: SAW-2015-00895
State permit:64-15
County: Carteret
Thanks,
Liz Hair
Project Manager
USACE-Wilmington District
Wilmington Regulatory Field Office
69 Darlington Avenue
Wilmington, NC 28403
910-251-4049
[e-mail]

DCM Coordinator: s Permit #: (elf 16-
MAILING DISTRIBUTION SHEET
Agents: �2XIG( vVQGt�ic', /U r laa,&V Fbm., 51Qy 1�
DCM Field Offices N2 wpD /UC
Elizabeth City (with revised work plan drawings) 2p a
Morehead City' UU
Washington
Wilmington
US ACOE Offices:
Washington: Raleigh Bland
William Westcott (NC DOT)
Bill Biddlecome (NC DOT)
Wilmington: Tyler Crambley
Liz HargV
Cultural Resources: Renee Gledhill -Early
Public Water Supply: Heide Cox (WIRO)
Joey White (WARD)
DCM/ Shane Staples
Fisheries Specialist Gregg Bodnar
NC DOT: Ben Hughes
DMF/
Shellfish Sanitation: Shannon Jenkins
State Property: Tim Walton
Water Resources: Karen Higgins (Raleigh)_
John Hennessy (NC DOT)
Washington: Anthony Scarbraugh-401
Wilmington:
Joanne Steenhuis — 401
Chad Coburn - 401
DEMLR
Washington:
Scott Vinson-Stormwater
Wilmington:
Georgette Scott- Stormwater
Wildlife Resources: Maria Dunn
LPO:
Fax Distribution: Permitee
Agent #:.

DCM MHC DISTRICT Field Rep:
DCM Major Permit Coordinator: COURTNEY SPEARS Permit #: y—/S
MINOR MODIFICATIION DISTRIBUTION SHEET
Permitee: (�ApG C4,-ZvAa CAW"-,
Agent(s): /UuS p ra5i
PLEASE DISTRIBUTE TO THE FOLLOWING (Checked):
US ACOE Offices:
Washington:
V20i'2iiia%Tii
Marine Fisheries:
Shellfish Sanitation:
Water Quality:
❑ Raleigh Bland
❑ Josh Pelletier
Liz Hare
Tyler Crumbley
❑ Shane Staples
❑ Gregg Bodnar
❑ Shannon Jenkins
Washington: ❑ Anthony Scarbraugh-401
❑ Scott Vinson-Stormwater
Wilmington: Z Joanne Steenhuis — 401
❑ Chad Coburn - 401
❑ Linda Lewis - Stormwater
Wildlife Resources:
LPO & Local Govt:
Cc Distribution:
❑ Maria Dunn (WARO)
❑ Vacant (WIRO)
El
❑ Permittee
❑ Agent #:
❑ Other (specify):

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. SAW-2015-00895 County: Carteret U.S.G.S. Quad: NC-SWANSBORO
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Pendhee: Cape Carteret Baptist Church
Attn: Mr. Brad Smith
Address: 101Anita Fort Drive
Cape Carteret, NC 28584
Cape Carteret Presbyterian Church
Attn: Mr. Ben Burrows
100 Yaupon Drive
Cape Carteret, NC 28584
Size (acres) approximately 13 acres Nearest Town Cape Carteret
Nearest Waterway Deer CreeIc River Basin Boaue-Core Sounds. North Carolina.
USGS HUC 3020106 Coordinates Latitude: 34.690707
Longitude:-77.063968
Location description: The project site Is located on thvo parcels (6.86 acres and 6.07 acres), in waters of the U.S., south of NC
Highway 24, east of Anita Fort Drive, west of Yaupon Drive at the Cape Carteret Baptist and Presbyterian Churches, in Cape
Carteret, Carteret County, North Carolina.
Description of projects area and activity:
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number or Nationwide Permit Number: NWP 27
SEEATTACVED RGP or NWP GENERAL, REGIONAL AND SPECIAL CONDITIONS
Your work is authorized by the above referenced permit provided it is accomplished to strict accordance with the attached
conditions and your submitted application and attached information dated March 27, 2015 and most recent plans dated May
10, 2016. Any violation of the attached conditions or deviation from your submitted plans may subject the permittee to a stop
work order, a restoration order, a Class I administrative penalty, and/or appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide permit authorization is reissued and/or
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide permit. If the nationwide permit authorization expires or is suspended, revoked, or is modified, such that the
activity would no longer comply with the terms and conditions of the nationwide permit, activities which have commenced (i.e., are
under construction) or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case -by -case basis to modify, suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Quality (telephone [phone]) to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
prior to beginning work you must contact the N.C. Division of Coastal Management in Morehead City, NC, at [phone].
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers regulatory
program, please contact Sarah Hair at 910-251-4049 or Sarah.E.HaitYW.usace.armv.mil.
HAIR.SARAHA =..„„
Corps Regulatory Official: Liz Han °� ; """" Date: June 6.2016
g�naa

SAW-2015-00895
Expiration Date of Verification: March 18, 2017
Determination of Jurisdiction:
A. ❑ Based on preliminary information, there appear to be waters of the US including wetlands within the above described project
area. This preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
( Reference 33 CFR Part 331).
B. ❑ There are Navigable Waters of the United States within the above described project area subject to the permit requirements of..
Section 10 of the Rivers and harbors Act and Section 404 of the Clean Water Act. Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
C. ❑ There are waters of the US and/or wetlands within the above described project area subject to the permit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations,
this determination may be relied upon for a period not to exceed five years from the date of this notification.
D. M The lurisdictional areas within the above described nrniprt Are. h..,a haan idan*irioei ..naer ., ...o.a.,..e ....a:.... ore.....
Basis For Determination:
Remarks:
1 . Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation in USDA programs, you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B
and C above).
This correspondence constitutes an approved jurisdictional determination for the above described site. Ifyou object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsyth Street SW, Room 1 OM15
Atlanta, Georgia 30303-8801
Phone: [phone]
In order for an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5, and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by N/A.
**It is not necessary to. submit an RFA form to the Division Office if you do not object to tlie.determination in this correspondence."
HAIR.SARAH.EA.1r.w
Corps Regulatory Official: i
Sarah Bair °icn100'p0tt"ff0°
Date of JD: February 26, 2013
Expiration Date of JD: February 26, 2018

SAW-2015-00895
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we
continue to do so, please complete our customer Satisfaction Survey online at http:Hreeulatory.usacesui vey.com/.
Copy furnished:
NC Coastal Federation
Attn: Lexia Weaver and Todd Miller
3609 NC Highway 24
Newport, NC 28570
Electronic copies furnished:
Courtney Spears, NC DENR, ACM
Chad Coburn, NC DENR, DWR

Action ID Number: SAW-2015-00895 County: Carteret
Permittee: Brad Smith and Ben Burrows
Project Name: Cape Carteret Churches
Date Verification Issued: June 6, 2016
Project Manager: Sarah Hair
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn: Sarah Hair
69 Darlington Avenue
Wilmington, North Carolina 28403
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revolting the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee Date

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Cape Carteret Churches Pond Retrofit
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Spears, Courtney
From: Brian Rubino <[e-mail]>
Sent: Monday, June 06, 2016 3:15 PM
To: Haines, Andrew
Cc: Scarbraugh, Anthony; Spears, Courtney
Subject: FW: Broad Creek Marina and Breakwater
Attachments: D00051616-009.pdf
Andy,
I spoke to Anthony Scarbraugh about this project early last week and he did confirm that DWR will still have to produce
a Use Attainability Analysis with our new/current plan. It was conveyed to me that it is a statutory requirement for DWR
for any new marina. Based on the age of the nearby marinas (Bailey and Umphlett), DWR either was not required to
produce a copy of past UAAs or they do not have that information available. Do you have the ability to search available
databases going back to 1975 in relation to shellfish resources in this location? It is my understanding that DWR would
produce the UAA, but I would contact you or others to assist with gathering the relevant data.
Thanks,
Brian
Brian D. Rubino, P.G.
Vice President
Quible & Associates, P.C.
8466 Caratoke Highway, Bldg 400
Powells Point, NC 27966
P.O. Drawer 870
Kitty Hawk, NC 27949
t 252.491.8147
f 252.491.8146
www.guible.com
LEGAL DISCLAIMER
The information transmitted is intended solely for the individual _. u and may
contain confidential and/or privileged material. Any review, retra .,, matton or other use of or
taking action in reliance upon this information by persons or entit tnan the intended recipient is
prohibited. If you have received this email in error please contact the sender and delete the material from any
computer.
From: Brian Rubino
Sent: Friday, May 20, 2016 2:56 PM
To: 'Haines, Andrew' <[e-mail]>; Jenkins, Shannon <[e-mail]>
Cc: Daniel, Louis <[e-mail]>; Spears, Courtney <[e-mail]>; Rheubottom, Jeff
<[e-mail]>; Huggett, Doug <[e-mail]>; Peele, Roberti

Coastal Management
ENVIRONMENTAL QUALITY
June 7, 2016
Cape Carteret Baptist & Presbyterian Churches
101 Anita Forte Dr.
Cape Carteret, N.C. 28584
Dear Sir or Madam:
PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Secretary
BRAXTON DAVIS
Director
The enclosed permit constitutes authorization under the Coastal Area Management Act, and
where applicable, the State Dredge and Fill Law, for you to proceed with your project proposal. The
original (buff -colored form) is retained by you and it must be available on site when the project is
inspected for compliance. Please sign both the original and the copy and return the copy to this office in
the enclosed envelope. Signing the permit and proceeding means you have waived your right of appeal
described below.
If you object to the permit or any of the conditions, you may request a hearing pursuant to NCGS
113A-121.1 or 113-229. Your petition for a hearing must be filed in accordance with NCGS Chapter
150B with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27611-6714,
[phone] within twenty (20) days of this decision on your permit. You should also be aware that
another qualified party may submit an objection to the issuance of this permit within twenty (20) days.
The project plan is subject to those conditions appearing on the permit form. Otherwise, all work
must be carried out in accordance with your application. Modifications, time extensions, and future
maintenance requires additional approval. Please read your permit carefully prior to starting work and
review all project plans, as approved. If you are having the work done by a contractor, it would be to your
benefit to be sure that he fully understands all permit requirements.
From time to time, Department personnel will visit the project site. To facilitate this review, we
request that you complete and mail the enclosed Notice Card just prior to work initiation. However, if
questions arise concerning permit conditions, environmental safeguards, or problem areas, you may
contact Department personnel at any time for assistance. By working in accordance with the permit, you
will be helping to protect our vitally important coastal resources.
Enclosure
Sincerely, _
yDglas t.,rO167TV. Hugge
Major Permits Manager
N.C. Division of Coastal Management
Nothing Compares _
State of North Carolina I Environmental Quality I Coastal Management
400 Commerce Avenue I Morehead City, NC 28557
252-808-2808 T

NC Division of Coastal Management
Cashier's Official Receipt 0076
Received From:
Permit No.: \ 'ntk
(1
Applicant's Name:��p �� �^ F/I 14&G ''�t��{�
Project Address:
Date: 2015
$ l oo 00
Check No.: {,I� r/�
County: Clcyp -%i ,
! V
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applicant: -� ! a Ct kt -J i Date:
Signature of Field Representative: "'f "1 Date:
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