HomeMy WebLinkAbout75841D - Bufalinit >rCAMA i DAE s
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6LJGENERAL PERMIT
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Own,
Address of Property:
(Lot or Street #, Street or Road, City & County)
Agent's Name #: /r'�i1�/� [,/�ii?c�PA Mailing Address:
Agent's phone #: 2/O 6?e
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.
k !L I have no objections to this proposal. I 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 G uv�✓ter rat €��a i �tr�dir� do bra aft ,c ti1.;L%i !!. eto 0iiii or by calling 1-888-
4RCOAST. 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, lift, or groin 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.)
1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Print or Type Name
, j eme-le l/r
Mailing Address
etc/
City/St te/Zip
Qzi�
Telephone Number
Date
Print or Type Name
Mailing Address
City/State/Zip
5qO ? 11 -/ q )_lam 1
Telephone Number
- ,L �
Date
Revised 611812012
11
CERTIFIED MAIL RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONrWAIVER FORM
A jjrt.ss I P-:Ve I L t
A, I(-
iesz,
31 •
zxopmty aojacerl to the above r0e.r"r*d proparty the ridividual
, - - 0 h - Me aS 5.4jWn rl t e altdchiad drawifigjhc
tK.C5�av�lnj lAottl qirren !12r_%, Must bappvido w It -this lettf,-r
I kn'v ht-, tio: '. I'l fill,
if you hj,,* _,cj*cr*o.ns to what is being proposed you mast naldy the DM500" of Coastal
".v"goin"'t '>C4f' in wrlol"j with r? 10 days of receipt of this notice. Contact inf0fM800n f0f 0CV
offices is a.'aslawe *r ir or by calling 1.888-
4RCOAST No re3p*,ns* xs considered the same as no objOction H you have been not1fi*d by
coar"000 "I
WAIVER SECTION
bnainouse 1:11, or g-oiri filuSt 0e. Se'
ba,-x a �vam;e 14 15''ron my area of fi.larre1*1 3c04s$' Ul"eSS rawer; by me j
&-S.t.1 IID *Lvvc ,e, vau must initial the appopliAlo- HAn th, *
N to t
11 ha'VA try setr.ack 'eq d"enient
y.i !�!- do not -, Sh t o *te 15' Sett3C-
1propeny Owner 1r1prmA1j1nl (Adjacvnt Properly Owrl*r InformatiOft)
Letter of agent
have retained Mark Clements DBA, Clements
Marine Construction Inc, to make application for any and all permits needed to start
construction on the work requested for our property or properties.
By allowing Mr. Clements to make such applications I do understand that this will in no
way relieve the of any obligations to perform all work according to the building codes of
North Carolina, LAMA, DWQ or any other state and or county ordinances.
Signatur t� S--X S-76,
7 date L41 1 � �V
Contact information
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Mark Buealinl
FM CMzana BNk
5444
200.00 GP p75641 D
_. ____
52]2020
_
F and SS Marina CaNacmra Inc.
_ —
M_y Jones
-- _
PNCBank
8616_
_
_ _ 200.M GP #7W 1 D
_..
51272020
Ma h, LLC
James L-WSummer Real Y-M OA
Bank of America _ _
2417
_
_ 400.00 GP N76420D
5272020
Mantech. LLC
Ronald Guard
Bank M Amerca _
2418
S 200.00 'GP N76418D
5127- — _--
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416
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