88110_Kris Niebergall_20230202

.4,40("4-tt,LICAMA I I DREDGE & FILL Vg.,5 N° 88110 ABCD
t GENERAL PERMIT T #70e? Previous permit
Date previous permit issued
[—New I !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:
I5A NCAC I I Rules attached. n 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 I I CW n EW PTA n ES n PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): I I OEA n IHA UW n SPIMA n PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale:/" )
Shoreline Length `"`_i
Access Length I
Pier(dock)length - /-}r k.
Fixed Platform(s) 1 1
:AL
Floating Platform(s) t {
I
Finger pier(s) � i 1_ •
� �_ ,
t /
Total Platform area
tI
Groin length/# 1 I 1 i
Bulkhead/Riprap length j 1« '/�
Avg distance offshore 1 i i ,"__. 1
Breakwater/Sill I t` `� 'ti I ( ��
Max distance/length } t V I- l� lJ� ?fr.
p
Basin,channel , : 25 ► r� `�i
t „- /1 Cubic yards 1
Boat ramp 1 i r
r.
Boathouse/Boatlift 1
Beach Bulldozing I
Other I . . 44 ._ 1 v
+ ,,ti
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all
I - - `_ I I
SAV observed: yes no: :, pi c� r:. 1
/n i
Moratorium: n/a yes A I "� I - j I• 1 I Y I. .r: -
Site Photos: yes TioJ 1 I --"- ---< '---- ---- - - ,, 1
Riparian Waiver Attached: yes no- I
s :, ( 1 , : 1 ; i 1
A building permit/zoning permit may be required by:
Permit Conditions n TAR/PAM/NEUSE/BUFFER(circle one)
nSee note on back regarding River Basin rules
ElSee 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

ROY COOPER
La Governor
MICHAEL S. REGAN
Secretary,
Coastal Management - BRAXTON DAVIS it
ENVIRONMENTAL QUALITY Director
• BUFFER AUTHORIZATION CERTIFICATE FOR SHORELINE STABILIZATION !(
A riparian buffer authorization is required for shoreline stabilization activities within the Neuse and Tar-Pamlico River E
basins per Division of Water Resources(DWR) regulations 15A NCAC 02B.0233 and 0259. The Division of Coastal
Management(OCM)through a Memorandum of Understanding with the Division of Water Resources(DWR)has
reviewed your project proposal and has determined that the project as proposed compiles with the aforementioned
regulations. ff
Those activities covered by your Coastal Area Management Act(CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions-listed below.Failure to
comply with this BufferAuthoriiation may subject the property owner and the party(contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to$25,000 per day per violation: ,
a. Impacts: Impacts to woody vegetation from clearing and filling in Zone 1(begins at the most landward of either
normal water line(NWL) or normal high water line(NHWL)and extends 30 feet landward)shall be minimized to
what must be impacted for the sound installation of the shoreline stabilization project. Unnecessary clearing and
filling in the buffer is a violation of the riparian buffer rules.
2. Clearing& Grading:Clearing and grading of Zone 2(begins at the landward edge of Zone 1 and extends 20 feet
landward)is allowed provided that it is re-vegetated immediately and Zone 1 is not compromised,which includes
maintaining diffused (non-channelized)flow of storm water runoff through the buffer. '
3. Construction Corridors: Construction corridors are allowed for shoreline stabilization projects,but they must be
satisfactorily restored as described in condition 5 below,
a. Potential Overwash: For vertical shoreline stabilization projects(bulkheads)only;sites wherie wave overwash is
expected to be severe, the first ten(10)feet landward (unless specifically authorized otherwise by DCM)from the
structure may be maintained as a stable lawn in order to provide for structural stability.
s. Temporary Stabilization: Immediately post-construction, bare soils must be stabilized as quickly as possible by
providing a temporary ground cover. Newly seeded areas should be protected with mulch and/or erosion matting.
This ground cover is a temporary measure used to address erosion until site restoration can be accomplished.
O. Site Restoration:At minimum, pre-project site conditions must be re-established°A site that was wooded prior to
this shoreline stabilization project must be restored with woody vegetation eta stem density of 260 stems per acre.
Non wooded sites may be re-vegetated with woody vegetation. Restoration must be completed by the first
subsequent planting season (November 1 through March 30)after completion of the bulkhead.
a Pre-project site conditions: 20( /S L'/e-✓ems/
7. Project Drawing:The drawing on the CAMA General Permit is considered the project drawing of your property
indicating the location of the shoreline stabilization structure and any associated clearing, grading,and construction
corridors.This drawing will be used to aid in compliance and monitoring efforts.
By your signature belo� you a e to be held responsible for meeting all of the above listed con itions nd that all
information iscom €t na c ate.
r ;
Agent or A pima r Pr a'• d?4 e Pe mit ear's Signature
1tt. g ve /�
Agent orApplicantSignature ( Isssu y Oat1Z�
CAMA GENERAL PERMIT#: //t
Sate of North Catalina I Environmental Quality Coastal Management
Washington Office 1943 Washington Square Mail Washington,NC 278891 252-946-6481
Wilmington Office 1127 Cardinal Drive c„.t wn.ninger NCoa105-384g1 2:0-195-7215
Morehead City Office l 400 Commerce Avenue Morehead City.NC 28557 ; 52-808-2808

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Kris Niebergall
1323 Rodessa Run
Raleigh,NC,27607
12-15-22
Louis Bonos
343 Baldwin Lane
Staunton,VA 24401-8985
Dear Mr Bonos:
I'm writing to you regarding the attached waterfront improvement and dock application for my property
at 153 Queen Anne's Ct, Oriental,NC. The parcel is shown on the attached drawing as Parcel 15,which
is contiguous to your Parcel 14, also in the Cloisters,Oriental,NC.
Per NC Division of Coastal Management,I'm required to obtain a Minor Permit which requires approval
from the adjacent property owners for the work being planned.
The scope of work will consist of a natural looking erosion control berm made from approximately 120
running feet of waterfront border riprap(see drawing)with approximately 18"of topsoil backfill fill on
the landward side of the riprap berm. The riprap will follow the contour of the green Needle Sedge which
cannot be removed as shown in the photo. On the same permit,I'm requesting permission for a
walkway/boat dock made of pressure treated wood. The 4' wide walkway will extent approximately 40'
into Kershaw Creek and connect to a 5'x 20' dock/tiedown area.
I would greatly appreciate your approval and signature. I've included a self addressed/stamped envelope
for your convenience.
If you have any questions,please feel free to call me at 919-280-0070.
Kindestfishes,
Kris Niebergall
Attachments (3)

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Spivey, Kelly
From: Lou Bonos <[e-mail]>
Sent: Thursday, December 29, 2022 3:54 PM
To: Spivey, Kelly
Subject: [External] Queen Anne's Court Permit Request
CAUTION: External email. Do not click links or open attachments unless you verify.Send all suspicious email as an
attachment to Report Spam.<mailto:[e-mail]>
I am not opposed to, but object for now, improvements to Lot 15 until dimensions are provided of the boat dock to the
riparian property line of Lot 14.
Lou Bonos
343 Baldwin Lane
Staunton,VA 24401
540-849-4811
Please email or text back so I know you received this.
Sent from my iPhone
1

Spivey, Kelly
From: Lou Bonos <[e-mail]>
Sent: Wednesday,January 4, 2023 10:27 AM
To: Spivey, Kelly
Subject: [External] Re:Queen Anne's Court Permit Request
CAUTION: External email. Do not click links or open attachments unless you verify.Send all suspicious email as an
attachment to Report Spam.<mailto:[e-mail]>
Follow up:
I contacted Kris Niebergall on 12/31/22 and requested drawings with dimensions of the proposed walkway and dock in
relation to my riparian property line. Mr. Niebergall stated he would send the requested drawings to me. I have not
received the new drawings yet. I will respond again when I receive them.
Thanks,
Lou Bonos
Sent from my iPhone
>On Dec 29, 2022, at 3:53 PM, Lou Bonos<[e-mail]>wrote:
>I am not opposed to, but object for now, improvements to Lot 15 until dimensions are provided of the boat dock to
the riparian property line of Lot 14.
> Lou Bonos
>343 Baldwin Lane
>Staunton,VA 24401
>540-849-4811
> Please email or text back so I know you received this.
>Sent from my iPhone
1

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N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION (MINOR PERMIT)
CERTIFIED MAIL, RETURN RECEIPT REQUESTED or HAND DELIVERED
/2- tf-zz.
99 Date
k12M2.12.0 J A r- eAtptat>lv
Name of Adjacent Riparian Property Owner
/6-12 6C44-&- N ,4-a/NE, G 7—
Address
Ov«44 285-1
City,State Zip
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
epA.02o/..4--r t.c1Arr6721 olt,7-tc*x/G ,4pp/zo)t /20 '0f 4;7:2,4p//k j,12,2)/A,C e7o,4'rZ k
on my property at /S3 iV /-NNE'$ Cr
in FfAtZt4 o County,which is adjacent to your property. A copy of the application and project
drawing is attached/enclosed for your review.
If you 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 and send your correspondence to:
(LOCAL PERMIT OFFICER,NAME OF LOCAL GOVERNMENT, MAILING ADDRESS CITY,STATE,ZIP CODE)
If you have any questions about the project,please do not hesitate to contact me at my address/number listed below,or
contact(LOCAL PERMIT OFFICER) at(PHONE NUMBER),or by email at: (LPO EMAIL).
Sincerely,
4eZerv-re..// /lam-ZSo- o0.7a
Property Owner's/Name Telephone Number
Address City State Zip
V I have no objection to the project described in this correspondence.
1 have objection(s)to the project described in this correspondence.
115-123
Adjacent Riparian Signature Date
u 1 l u-x Y 2S z - b S - O `E 4 6
Print or Type Name Telephone Number
/62 datieE7v , ,1,L/65 C T tVG .Z85''7 J
Address City State Zip
Revised July 2021

9
TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners (15A NCAC
7J.0204(b)(5)). Proof of actual notice (a sign-off by the owner on this form) or certified mall return receipts (showing
delivery of notice)are needed, or any other method which satisfies the Local Permit Officer(LPO)that a good faith effort
has been made to provide notice.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development so that they
have an opportunity to provide comments (or potentially object to) the proposed development, and to give DCM or the
LPO an opportunity to consider these comments/objections before a permit decision is made. "Permission" of adjacent
property owners is not necessarily required for DCM or the LPO to issue a permit. It is in the applicant's best interest to
provide comprehensive and accurate notice so that any concerns or objections can be resolved early in the permit review
process. In addition, if the adjacent riparian property owner appeals the permit decision, insufficient notice could be a
basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent? (Note: DCM reads this broadly to ensure comment by potentially impacted neighbors)
• A property that shares a boundary line with the site of proposed development;AND
• A property that fronts a natural or manmade waterbody that is connected to coastal waters and can support some
form of navigation,even a kayak or canoe,including a common canal system or a manmade basin.
• Easement holders?Yes,if the easement could be impacted by the proposed development.
• Streets/Roads?Only if the street/road could be impacted by the proposed development.This might include street-
ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide?If there is a question about
whether an adjacent property is considered "riparian," please reach out to DCM Staff or the LPO- especially on the
oceanfront beach where there may be undeveloped parcels on the beach or in the water.
Who/What is a Property Owner?
For private individuals (or families), send notice to the address listed on the tax card. If the property is owned by an Inc.
or LLC,please send notice to the person listed as the registered agent on the NC Secretary of State's Corporations Look
Up site: https://www.sosnc.gov/search/index/coip. For Condominiums or neighborhoods, with an owners' association
(HOA/POA), send notice to the association (which is usually a corporation, for which you send notice to its registered
agent).
What is Notice,and how do I ensure it is received?
• You can meet with your adjacent property owner,provide a description or drawing of the proposed development,
and ask them to sign this form and return it to DCM or the LPO;OR
• You can hand-deliver this form and a description or drawing,and ask your neighbor to return it to DCM or the
LPO(consider providing them with a stamped envelope);OR
• You can mail this form by USPS Certified Mail,return receipt requested(the Green Card).If you choose this
option,you must provide either the signed&returned green card OR track the certified mail package number on
USPS.GOV's online tracking system,and provide the tracking print-out as proof of delivery to DCM or the LPO
If you have any questions about this process,please reach out to the LPO,DCM Staff and DCM Legal Counsel and we
will work to answer your questions.
•
Revised July 2021

Locality Permit Number OTHER PERMITS MAYItE REQUIRED:The activity
yyau are planning may require permits other than the CAMA
minor development permit.including,but not limited to:Drinking Water Well,Septic Tank(or other sanitary waste
Ocean Hazard_Estuarine Shoreline_ORW Shoreline Public Trust Shoreline Other_ treatment system),Building,Electrical,Plumbing,Heating and Air Conditioning,Insulation and Enemy Conservation,PIA
(par official use ono) Certification,Sand Dune,Sediment Control,Subdivision Approval,Mobile Home Park Approval,Highway Connection,and
others.Check with your Local Permit Officer for more information.
GENERAL INFORMATION
STATEMENT OF OWNERSHIP:
LAND OWNER-MAILING'ADDRESS I.the undersigned,an applicant for a CAMA minor development permit,being either the owner of property in an AEC or a
Name /�.�/5 N Au- person authorized to act as an agent
for poses of applying for a CAMA minor development permit,certify thin the person
listed as landowner on this application has a significant interest in the real property described therein.This interest can be
Address l 32-3 /20DE554 Pert-(J described as:(check one)
City ?Zi4Gt,Ge/ N a 607 179-280-oo 70 ✓ ,�/ /�H State C ZipPhone anawnerorreeordtiue,Tidcisvestedinmmeo! �irj ,y/E-{� W ,Q�L •
Email ¢' /2/ 5 7 &t EAx)e a c O - C OM
y( sec Deed Book (Q� page rr���in the anti.,Le 0 County Registry of Deeds.
60s-
AUTHORIZED AGENT _an owner by virtue of inheritance.Applicant is an heir to the estate of
Name ;probate was in County.
Address if other Interest,such as written contract or tease,explain below or use a separate sheet&Whichto this application.
City State Zip Phone NOTIFICATION OFADJACENT RIPARIAN PROPERTY OWNERS:
Email I furthermore certify that the following persons are owners of properties adjoining this property.I anon dial have given
ACTUAL NOTICE to each of them concerning my intent to develop this properly and to apply for a CAMA permit. 29fl/
LOCATION OF PROJECT:(Address,street name and/or directions to site;name of the adjacent tvaterbody.) (Name) (Address)
(I) lc44722 )V -Puitit< /sz &astv,4tvNs5 err G2eS{1.-,/vG
ik
/6-3 eCiets,v A-tfriVE1 /°-- (2) dOtt/S &Woos 343 7340w/a LNI erkmer27,404,
OE( .qt / Nc- .20S7l (4) 44ol -BgBs
DESCRIPTION OF PROJECT:(List dlproposed construction and land disturbance.) eS? .'t• reiDAJ ACKNOWLEDGEMENTS:
6.04/ L %zlfp 7 /44 13O,R•( DOL' 1,the undersigned,acknowledge that the land owner is aware that the proposed development is planned for an area whirl
/ may be susceptible to erosion and/or goading.)acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot.This explanation was accompanied by recommendations concerning stabiliza-
SIZE OF LOT/PARCEL: 43/38SSPre feet •f4'6 acres lion and floodproaftng techniques.
PROPOSED USE:Residential❑ (Single-family❑ Multi-family 0) Commercial/Industrial 0 Other [y"" I furthermore certify that I am authorized to grant,and do in fact grant,permission to Division of Coastal Management stall;
COMPLETE DITHER(I)OR(2)BELOW(CnnlanyunrWrn/PrrndlOfJicer if you are nnfsure which AEC applies the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
related to this permit application.
to CyMPLETE EI ; �.�.,�.��
(I) OCEAN HAZARD AEC::TOTAL FLOOR AREA OF PROPOSED STRUCTURE: ;This the /.j da -�r,�•�
N�square l(includesY of 20 Z�
aicwnditioned living space,parking elevated above ground level,non-conditioned space elevate above ground level but S
excluding non-load-bearing attic space) �
Landowner or person authed d dactashis/her agent for purpose of filing a CAMA penult application
(2) COASTAL SHORE INEAECs:SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: square feet(includes the area of the foundation of all buildings,drive ays,covered decks, TGLv applicationtactaria:general Lfrnrrartun(IGisfurvn),asite drawing as denrrlhedun the back of this opplieatinn,trio
concrete or masonry p dos,etc.that are within the applicable AEC Attach your calculations with the project drawing.) ownership statement the Ocean No=anl AEC Notice ahem necersoy,a check fits$/flu od wade payable to the locality,and
any infnrvna,ian as tiny be pmvitlel orally by the applicant The details of the application as described by thesesousra rue
STATE STORMWATER MANAGEMENT PERMIT.Is the project located in an area subject to a State inrmparared without rxfrrcnce in anypernrit which env be issued.Deviationfmm these details'will constitute a violation of
Stonnwater Management Pennit issued by the NC Division of Energy,Mineral and Land Resources(DEMLR)T tow permit.Any pesos developing in en AEC without permit is.subject to civil,criminal and administrative action.
YES NO
Ifycs,list the total built upon area/impervious surface allowed for your lot or parcel: /.//4- square feet.

SITE DRAWING/APPLICATION CHECKLIST
Please make sun:your site drawing includes the following information required for a CAMA minor development permit. by
use Local Permit Officer will help you,if requested. - r
APPLICATION FOR Pc
PHYSICAL DIMENSIONS f?'
�1 ibd mats
CAMA MINOR z
!/ Label highways right-of-ways
tC Label local setback lines DEVELOPMENT
7➢�i Tf ®1D�/(I7G+AT�
✓ Ceded any mid all structures stud driveways currently existing an pmpcdy Coastal Management
11Y1S`J '6' 1L L S 1TJiliJ1V
ter Label adjacent waterbody ENVIRONMENTAL QUALITY
PHYSICAL CHARACTERISTICS PERMIT
✓ Draw and label normal high water line(contact LPO for assistance) In 1974,11te North Carolina General Assembly passed the Coastal Management Act
✓ Draw location ofon-site wastewater system (CAMA)and set the stage fur guiding development in fragile and productive areas dint
bonier the slate's sounds and oceanfront.Along with requiring special care by those who
Ifyon will be working in the pecan hazard area: build and develop,the General Assembly directed the Coastal Resources Commission
Dmw and label dune ridges(include spot elevations)
Draw and label toe ofdines (CRC)to Implement clear regulations that minimize the burden on the applicant.
Identify and locale first line of stable vegetation(contact LI'O Ibr+ssislancc)
Dnnv and label erosion setback line(contact I.1'O for assistance) This application for a minor development penult under CAMA Is part of the
Dmw and label topographical features(optional) Commission's effort to meet the spirit acid Intent of the General Assembly.It has been
designed to be straightfonsard and require no mom(lute or effort than necessary from
Ifyou will be:working in a coastal shoreline area: the applicant.Please go over this folder with the Local Permit Officer(M O)fur the
//[/,g Show the roof overhang asacloned line animal the structure locality in which you plan to build In be certain tlml you understand what Information be o
✓Dniw and label landward limit of AEC or she needs beforeyuu apply: y
y,tw and label all Welland lines(mead LW lie assistmee) t'
✓Dmw and label the 70-foot buffer line Under CAMA regulations,the minor permit is to be Issued within 25 days once n
DEVELOPMENT PLANS complete application Is In lamed.Often less lime Is needed if the project Is simple--Din
_ process generally lakes about 18 days.You can speed(lie approval process by nothing
fr.."''Diaw and label all proposed structures certain that your application is complete anti signed,that your drawing meets the
v Draw and label areas that will be disturbed and/or Landscaped specifications given Inside and Mal your application fee is attached.
Note size of piling and depth to be placed in ground
Draw and label all areas to be paved or graveled Other permits are smndintes required for development in the coastal area.While these
Q/ Show all of is to be disturbed lire lintCAMA-related,we urge you In cheek with the Local Permit Officer to deterndne
L-Slow landscaping which of these you may need.A list Is Included on page two of This folder.
NOTE TO APPLICANT
We appreciate your cooperation with the North Carolina Coastal Management Program
Have you: and your willingness to build in n way that protects the resources of our beautiful and
• completed rill blanksand/or indicated if not applicable? productive coast.
• notified and listed adjacent property owners?
• included your site drawing? Coastal Resources Commission
• signed and doted the application? Division of Coastal Management
• enclosed the S 100.00 fee?
• completed IIII AEC Hazard Notice,ifnecessary?(Must be signed by the property owner) - y m
FOR STAFF USE (? C
Site Nolan Potgd_idol Iaspeclion _ Fee Received ,— ElQtMd1 (13"
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