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HomeMy WebLinkAboutGladwell, Charles & Vauter, Ray (need Permit No.))C --.=-- t3 REOGE I FILL E NERA L PERM .",,.,,",, ',, ',,n,, n. F tL-r-*'' r"( ir.-r'-r')'rnt/ u i-Lc J \J- r ) LL] 1..1 I ) { (t'. rt ) Ittw c\)\L\. i( | ,, ..,t) ),Jle )v4'-tt-U)()I ( ,,'l]I1' i---.riE- ( t (t (/lt.L )7l?04 Clorest Mal Wtr BodYt Ttp. ol Pro,e<t actw't} - - /r)ir."*l', .tcx}C' **11*"rrl:AE*J*e*, zs94- ^ Pur.p= a&l0Y -islal=q,^St lr ? 7-J wfl,\r' U -za- 8€a<. guibor'n8 *"..!<4 .A-O l,{-'ft,t" I vt e,{ei( 6 A buld'nt P€rm't may bG req'''rcd b,See note on back regardrnS RNer Easan rules. , Nore Lo(.l P'annmt lunsdicoon) N a4- FeeG) Ari '-_.e. I\,1 t,l Y'\,,,q\ t ,, :1.'.'4r:,I ) \.* t{"* 4 J- -ll %*#_M- ? o{&."1- t L ') thzB)lliaB.a'f?q,/a-cltzt(horlz.s Glt)w.rt Name ol Propeny Owner Requestrng Permi: furlailing Address Phone Number Email Addrcss: 2t4 ,,":lu. - 33 b-.t')-4qoa I certity lhat lhave authorized --TGG UPG A ,4tn EmAnAOnnrL , co/r1 / o <-k -i-o rn to act on my behall, for the purposc of applying for and obtaining all CAMA permits necessary Ior the following proposed development '|-+ L Environmanll kfOi c-o,LDL to a-a ) floa-ka1 at my propcrty located al l!a- $ayv ) -v,)Btvl, *+t a"tti c- Dzach NC In ,-1r-tLral-County I fudhermore cedily that I am aulhoized b gran'' and do in facl Dtvision of Coaslal Management slaff, the Local Permil Oflicer and oi tni ,fon*"ntioned linds in conneclr:,n w h evatuating inlorm permil apqlical,on. Property Owner lnformation: g@nt permission lo lhcir agents to enter alion related to :lgnalurc&t|&Les .,ht,dare /,L Pthl or Type Name 0-uw"lJ 04,t4 t RECENED $AY 0 5 20zs DGM'MHDCTTY Oalc Tie 3_421 AGENT AUTHORTZATION FOR CAMA PERMIT APPL-ICATION hrru*lr;tu -AL-AlA/o - TOm hrraon uJ of I hereby certify that I own property adjacent to L' Name of Property Owner) €LAn"e{ property located at (Address, Lot, Block, Road, etc on AoLot Souti ,in N.C. (Waterbody)(City/Town or County) The applicant has described to me, as shown below, the development proposed at the above I have no objection to this proposal. I have obiections to this proposal. 0rritvt' flnss't rl- fiF*, lot WA]VER SECNON I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift" or groin must be set back a minimum distance of 15'from my area of riparian access unless waived by me. (lf wish to waive the setback,you must initial the appropriate blank below.) _ I do not wish to waive the 15' setback requirement. (Property er lnformation (Adjaeent Owner lnformation) 0f at a Signature Pa.l UA,,,7 511- Sign /bsoor Prlnt or Type NameIli otAv€ t^)Pdnl or 13o Name Mnfig Addtess Lxt /c Cilu/SlatelziD z{z- 270 -el6e Telephone Number / email address Telephone addl'sss z o7ai -ro-ld D (Relilf(d,tA.M) OCM.MHDCIW $u ,,i " a- /1 Date 'Valid for one calendar year after signature' Date* Number ADJACENT RIPARIAN PROPERTY OWNER STATEMENT '"TJ'o#---T.-l- DESCRIPT]ON AND/OR DRAWNG OF PROPOSED DEVELOPMENT (lndividual proposing devetopment must filt in description below or attach a site drawing) I do wish to waive the 15' setback requirement. RTY NE TAT T i of Propcdy Owncr) ress, L ol. Bl Ii rn q.l -l __,3 J*4 (_ AC ARIA P TtOP I hereby cerlrfy that I own proPerty ad,accnt lo property locaicd at :)A NC Tire aoDlica ttcatior./lcl- (Cityn'own and/or cou.rtY) trthasdescribedtome.assho{,nbelow'thedeveloPrnentproposcdallheabove I have no obicclion lo tlns proposal t have obiections to lhls Pro,rosal .J t l DESCRIPTION ANOIOR DRAWING OF PROPOSED DEVELOPMENT dcscription below or attach a sile drawing)(lnlividual t ? i'h2' it) g deYctopment must till itt\ u .] c. il-ll i"s s''a fk, flar,.'Ny Flal> UJ VER SECTION I undersland lhat a pier, dock. mooring Piling must be set back a minimum distance of 15' me. (lf you wish to waive the setback. you mu Cj- ,dc wish tc waive lhc J5'setback reqrtirement ldo not wish to waive the 15'seltracl' reriuirenlent s. troat ramp, breakwaler, tloalhouse, lth, or groin from nry area of riparian access unless t,'laived by st initial the apFropriate blank bclow ) (Property Own lnfo ,"9 (n (ljiiuent Propcrty Owner lnformation) -r' .OtvL lad*-e LL e4/.loed. 3 \_-/t\" (p5o--S4 t( :"21YoI79'Lq:: It 6n .:\ (.'lliffiI'+l OL ,l (Rr.v6.2.t Aug 2Ol4J RECENED MAY 0 5 2020 DCU.MHD CITY 'Valtd l.,r O e Calenda, _veaffifler ::Qnrlur!1' i)r'*, n {Waterbody} 'l.4,o*Lt- t.' | 7.' l-t^,.r.eL ol'i i<- -? rl C.] 'l4rd _ a vb1