HomeMy WebLinkAbout63101D - Starzanski
plicant:
te: % t
.` v S' L� Permit#:
l"
(Z-11--1;
scribe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
nd in your Habitat code sheet.
itat Name DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
_ 1
Dredge ❑ Fill ❑ Both ❑ Other
�,
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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MUELLER & PITTMAN, INC.
218 PARKWOOD DR
JACKSONVILLE, NC 28546 D-e-c- to Q
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P �to the � J-� � '� I $ oe
jorder o
0014ia,s
First Citizens
Bank
(03/a/-P
1110010030 1:0 5 3 100 3001:000 76 L 369 L8 7111
PERMISSION TO ENTER PROPERTY
I hereby grant permission to 14AMM1,o. L%ak and his or her
contractors to enter my property located at $tyq A. , Unit
No. , Lot No. in (city) (St), for
the purposes of:
Ce►rS�uvEi,1� '46ArK vices
Dated: J2- ►�- �ct'3
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Signature
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Printed Name
AV
16 a- 514 4
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12" Diameter
Piling (Typical)
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Flood
Line
3' Finger
r Pier
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DEC-10-22013 10:11 From: To79i—j272387 P,2/3
CERTIF, fED MAIL • RFT $N RECEEAT 8gQy99
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Nbtne of Property Owner:
Address of Property:
(Lot or Streetfit, SOW or Road, City & County)
Agent's Name t l' C r cr ) %lea ^ Mailing Address:..
Agent's phone #: —qi Q AN ��r.—/L� ' -""$` 4o
I hereby certify that I own property adjacent to the above raferonced property, The Individual
applying for this permit has described to me as shown on the attached drawingthe development
they areproposing, AAglifl tljgi2nor drawing, ah dimensiong.,mu tombs provided y& this let#sr.
_46L f have no objections to this proposal, I have objections to this proposal.
# you have objections to what is Doing proposod, you must oodlythoDivlslon of Coostalmanagomnt(DCM) In
wilting *0111 IQ days of moalpt of this nodoo. Correspondanoo should ba minted to 127 Cardinal Drive W.,
iNlhttlttgton, NC, 2"65.3846, DCH ropresentativas can also be contaoted at (010) 796.1216. No rosponso Is
consldyrod the" "me ar no obj"Von Ifeu have bean notlilad ht Ca tied Marl,
� wwrYMi4M����,�1+�1�we�a�aiYl��I:
WAIVER SECTION
I understand that a Afar, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 16' from my areo of riparian access unloss waived by me, (If you
3 wish to waive the setback, you �,(WU the appropriate blank below,}
— . J ,1 do wish to Welve the 161 setback requirement.
I do not wish to waive the 16' setback requirement,
Signature
4 — �17_ 3kl __ , ..
t or Type Alamo
Maan}gas
-� AddreGJ
W
(Adjacen "Property wnor Informstlon)
j
signature
6&y
Print or Type 6-yh,) Aki-
y�ty' zy�I.�, r
Mailing Andress
D5C-10-2013 10:11 From: To-% j272387 P.2/3
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
% r
Nome of Property owner; Ahn &—�tn-
Address of PrBperty Lt r�1 f ,r��l . '� t ;ac�x 4) Q
(t.ot or street#, street or Road, City & County)
Agenfs Name* ��£�� tr� MaliingAddress;` •`540
-
Agerrt'a phone #:
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, tye rll}tion,pr drawlnc wl h ¢irrsenslon +st be rovided wi th thi„ s letter•
I have no ol�lectinns to This proposal, I have objcotioaxs to this proposal.
1r you have ab/octions to what is bGing prapapod, You must notify the Divltfon of cooatal managan°ront (Dt`M) In
writing wlthilr t0 days of rvaelpt at this rsotiaa. Correspondence should be mallod to 127 Cardinal Drip=e Ert.,
w1mbf8ton, NC, 284054848. DCM represontotivas can also be conacted at (910) 796.72M No set lsonso is
consideredtbo sense as no obJection Ify Nava been rra!Mad to Cort/tled Mail,
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or grain must be set
back a tr inirnum distance of 15' from my Brea of 6panan access unless waived by me, (It you
wish to waive the setback, you 1t p the appropriate blank below,)
i do wish to waive the 16' setback requirement.
I cto not; wleh to waive the 16' setback requirement.
Signature
�rintD7yps iV�e/tns
Mating Address y/ 1
(A Jac- n'`fsrapa�t4ty/� wrtortnf rmatlomn
le i.
Signature <
Print or Type Narq� )ryr7f� iY�;;/�;rr f>%<
Mailing Andress
)EC-10-2013 10:11 Froin: rc:9103272387 P.2/3
CERTIFIED MAIL - RETURN RECEIPT REQU99=
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Namr.r of Pronert; Owner
tQ%
Addr eats of Pioper y:
(lot or Streett Street or Road, City & Cormty)
Agent's Warne#; l-�� -dal e-
Hf}errt's /i"�L�G�
I hereby oert4 that I oven property adjacent to the above refe,renood property. The individual
applying for this permit has described to me as sho'M7 on the shached drswing the dovetoprnent
they are proposing, AAftserjpIon or drawitt�g�wit_h dimensfgre ug) i,e grovi Act' ' t i s ems.
)' gave no ohicctions to this proposal, _ _1 have objections to this proposal,
lr you have ob/octtons to what is balm proposed, you mu.-t nnt%, the D1v1.1iun at Gooatul&iunogomant fCtt;R}) In
writing within 10 days of rocelpt of this notico, Cormsponaenvo ahould bo mnliod to 127 Cardinal Arlva EA,
147lmington, A/C, 28406.3846, DCIf ropresentut(vea can atso be ctmCsatod of (910) 706.721R. No r"ponso Is
considerod tiro soma os no ob ocdon If vau have boon nvttgsd b !Mall.
INAWR SECTION
I understand that a plar, dock, mooring pilings, breakwator, boathouse, IIft, or groln r'tiust be set
back a minimum distance of IS' from my virea of riparian las pass unloes waived by rno, (It you
wish to waive the setback, you.rijuALtaW th3 appropriate b1snk below.)
I do v ish to waive the 16' setback requirement.
I do sot wish to waive the 16 setback requirement.
Irk" Lit 4, d 5
(Prnperiy, fawner in rmation) (Adjacont iroporty woor information)
SFgnature Signature .-
Print or Type Nems( -7 J
Mailing Address
Print or l"ype Nara
Moding Address