HomeMy WebLinkAbout78713A_Collier, Betty_20201104f2�
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: _j!2W Collier.
Mailing Address: 2730 Blithe Dr
Chester. VA 23831
Phone Number: (8041748-5716
Email Address:
I certify that I have authorized Albemarle Bulkheads & House Pilings. LLC
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: install new vinyl bulkhead,
at my property located at 288 Grias Acres Dr
in CuIt County.
! furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
e Co /1 )z_
P 'nt or Type Name
Title
9 / 17 12...a.-;_tp
Date
This certification is valid through 1 1
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: & A n ed I I I e v
Address of Property: �9 �l V t �(1 S r1 t Y t' f Y )U i 17 i LL d w ✓ , n%L
(Lot or Street* Street or Road, City & County)
Agent's Name #: A.11Wtt -0 &4 ( [,(yd C Mailing A7ddress:
Agent's phone #: Z 5 Z U I "1 (r 4 KI �>' U-i t! + t I (� S ill - Z 7 9 i
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 dra�_ng'with dimensions must be Droyided ynth this letter.
O,Q�__ t have no objections to this proposal. ____ _ I have objections to this proposal
If you have objections to what is being proposed, you must notity the Division of Coastal Managemen t
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
availableat wve r casto;rnar)agernent.neVweb,!crrilstaff-listin orbycallingi-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Marl.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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 vnsh to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
—w-k
(Property Owner Information)
Signature
Print or 73fpe Name
'2130 Psittkp D�
Mailing Address
c( -ec4- r. V ti3k3�
City/State&ip
Telephone Number / Email Address
(Riparian Property Owner Wormation)
i
Sijnat e /
Ulm k+ K)��e��
PdW or Type Name
2�12 OxI Q61� Atrei l>r
Maifarg Address
�lJ ► �- HTA VhtiY , lU 2 lv 5�
City/Wate/Zip
2 S'� < —'�— 7/
Telephone Number/Email Address
%c"— B--Z_o;,-
Dare Date
(Revised Aug. 2014)
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWANER FORM
Name of Property Owner. �),Q " C 0 i ( I i 4� ,, ff __
Address of Property: 2 C'jy' i1 G t a 1� ( PU , n f li�l I %(ii - /V L_
(Lot or Street #. Street or Road, City & County)
Agent's Name #: ,K l�'1 Y byte 1 i L( Mailing Address: G G
Agent's phone - I � 1-111 �V if 14 S ,V
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
re .
-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 rttarragernent
(DCM) in writing within 10 days of receipt of this notice. Contact in/ormation for DCH pukes is
availableat http ,,' www.nccoastalmanogement.net/weblcmistaH-listing orbycnffft 14=-IRCOAST.
No response is considered the same as no objection if you have been notfrfed by CerWled Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.
J 1 do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Print or Type Name
21 2>0 6114 ►v.e D r
Mailing Address
C h.? S4-( f
\JA 23q31
City/stateop
(Riparian Prop rty Owner Information)
Signature
P-� K LLB
L
Print or Type Name
113o 1,-om r-LI
Matting Address
C k a ► Ic4e k, i I(l Ui -Z O/
CO State/Zip
Telephone Number/ Email Address Telephone Number / Email Address
^_ I t> 5 20
Pale Dal
(Revised Aug- 2014)
Albemarle Bulkheads and House Pilings
Post Office Box 50
Kill Devil Hills, NC 27948
(252) 26 t -7466 Office
(252) 715-1986 Fax
whifpatterson0857 ftrnail. corn
albemarlebulkheadsobx C>_gmail.com
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Whit Patterson
Owner/ Operator
Z88 6- aK & r-t s Dr P.
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Waterfront Solutions! I
...through quality workmanship and environmentally sensitive marine construction!
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