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HomeMy WebLinkAbout20170738 Ver 1_CAMA Application_20170613Coastal Management ENVIRONMENTAL QUALITY June 9, 2017 201 70738 TO: Karen Higgins 401 & Buffer Permitting Unit DWRMater Quality Permitting FROM: SUBJECT Applicant: Heather Coats, Assistant Major Permits Coordinate NCDEQ — Division of Coastal Management 127 Cardinal Drive Ext., Wilm., NC 28405 heather.________...___....,__ Fax: 395-3964 (Courier 04-16-33) ROY COOPER Governor MICHAEL S. REGAN Secretary BRAXTON DAVIS Director CAMA / Dredge & Fill Application Review Rex Bost Project Location: 7038 7th St., adjacent to Stump Sound, in Surf City, Onslow County Proposed Project: to replace and existing bulkhead Please indicate below your agency's position or viewpoint on the proposed project and return this form to Heather Coats at the address above by July 2 2017. If you have any questions regarding the proposed project, contact Jason Dail at (910) 796-7221 when appropriate in-depth comments with supporting data is requested. REPLY: This agency has no objection to the project as proposed. **Additional comments may be attached** This agency has no comment on the proposed project. This agency approves of the project only if the recommended changes are incorporated. See attached. This agency objects to the project for reasons described in the attached comments. SIGNED DATED State of North Carolina I Environmental Quality I Coastal Management 127 Cardinal Drive Ext., Wilmington, NC 28405 910-796-7215 DIVISION OF COASTAL MANAGEMENT FIELD INVESTIGATION REPORT 1. APPLICANT'S NAME: Rex Bost 2. LOCATION OF PROJECT SITE: 7038 7' Street, Surf City, Onslow County, NC. Photo Index — 2006: 26-6487, 0-12 State Plane Coordinates - Lat: 34°26'53.03"N Long: 77°30'54.13"W 3. INVESTIGATION TYPE: CAMA/Dredge and Fill 4. INVESTIGATIVE PROCEDURE: Dates of Site Visit — 6/8/17 Was Applicant Present — No 5. PROCESSING PROCEDURE: Application Received Complete — 6/6/17 Office - Wilmington 6. SITE DESCRIPTION: (A) Local Land Use Plan — Surf City County Land Classification from LUP — Developed / Conservation (B) AEC(s) Involved: EW, PT, ES (C) Water Dependent: Yes (D) Intended Use: Private (E) Wastewater Treatment: Existing - Onsite septic Planned - None (F) Type of Structures: Existing — Single Family Residence, existing bulkhead and private docking facility. Planned — Bulkhead replacement and new platform (G) Estimated Annual Rate of Erosion: N/A Source - N/A 7. HABITAT DESCRIPTION: [AREA] DRFDGFD FTf,i ED OTHER (A) Vegetated Wetlands - Coastal (B) Non -Vegetated Wetlands 550 sq. ft. 78 sq. ft. (Open water) (filled) (incorporated) (C) Other — High ground 1,100 sq. ft. (disturbed) (D) Total Area Disturbed: 1,728 sq. ft. (E) Primary Nursery Area: No (F) Water Classification: SA Open: No 8. PROJECT SUMMARY: The applicant proposes to replace the existing bulkhead and install a new platform over open water. Rex Bost Page Two 9. PROJECT DESCRIPTION: The project site is located at 7038 7t' Street, adjacent to canals of Surf City and Stump Sound, in Surf City, Onslow County. To get to the site from the Wilmington Regional Office, take US Hwy 17 N to NC Hwy 210 (approximately 15 miles) and turn right. Continue approximately 2 miles along NC Hwy 210 and turn right at the intersection of NC Hwy 210 and Rowland Ave. Travel approximately 1.9 miles along Rowland Avenue and turn left onto New River Drive. Continue along New River Drive for approximately 2.3 miles and turn left on Seventh Street. The subject property will be located along the right-hand side of 7`i' Street, at house number 703 8. The subject property is developed (residential) with approximately 55 linear feet of shoreline bordering the 7' Street canal. Elevations at the property range from 3' to 5' above the normal high water (NHW) line. The size of the tract is approximately 7,840 sq. ft., or 0.18 acres. Lawn grasses and ornamental landscaping make up the high ground vegetation and there are no wetlands on, or adjacent to the subject property. Just waterward of the existing bulkhead, the applicant maintains a private docking facility which consist of a short access pier and fixed platform (running parallel to the shoreline). Currently, the normal high water line approximates the existing bulkhead. The area surrounding the property is heavily developed. Immediately toward the east lies the adjacent property owners boat ramp and private docking facility, and on the western property, rest a small fixed platform. The two adjacent bulkheads extend approximately 6' waterward of the applicant's existing bulkhead. The Surf City Land Use Plan classifies the adjacent waters as Conservation. The waters of the canals and Stump Sound are classified SA and SA-ORW (respectively) by the Division of Water Resources. The waters immediately adjacent to the property ARE NOT designated as a Primary Nursery Area (PNA) by the N.C. Division of Marine Fisheries and they are CLOSED to the harvest of shellfish. PROPOSED PROJECT: The applicant proposes to replace the existing bulkhead and install a new platform over open water. The existing bulkhead is comprised of timber and was installed many years ago. The existing tie -backs that support the wall have begun to deteriorate and have cause minor "wash out" behind the wall. The applicant's current proposal includes construction of a new bulkhead approximately 10 -feet waterward of the existing wall. The applicant has indicated he, and the neighbor immediately west, would like to extend their walls to align with the neighbor located two lots over toward the west (7042 Th Street). However, the neighbor immediately west of the applicant has not indicated to DCM of their intention of doing the same. As designed, the proposed wall would be located approximately 10' beyond the current alignment, and would extend roughly 4 feet beyond the western neighbors existing wall. Along the eastern property boundary, the applicant proposes a 20 -foot returnjust inside the eastern neighbor's boat ramp. The proposed project would result in the unnecessary filling of approximately 550 sq. ft. of estuarine and public trust waters. High ground disturbance associated with the applicant's proposal would include grading and filling approximately 1,100 sq. ft. (dead -men and anchoring). Rex Bost Page Three In additional to the proposed bulkhead, the applicant is requesting approval for the construction of a new 6' x 13' fixed platform along the eastern side of the existing platform. As designed, the new platform would be uncovered and would be located just beyond (wateward) the alignment of the proposed bulkhead. Based on the information provided, it does not appear the applicant would encroach within the 15' riparian corridor associated with the adjoining property owner. 10. ANTICIPATED UAPACTS: The proposed bulkhead would fill approximately 550 sq. ft. of Estuarine Waters and Pubic Trust Area and approximately 1,100 sq. ft. of upland soils. The proposed bulkhead would extend approximately 10 feet beyond the existing wall. The proposed platform would shade an additional 78 sq. ft. of shallow bottom habitat. Submitted by: Jason Dail Date: 6/12/17 Office: Wilmington To: jason Dail NCDENR Fr: Gary Ange Agent for Rex Bost June 5, 2017 Jason, I am requesting a CAMA major permit on behalf of Rex Bost at 7038 7th St Surf City NC. This request if for extending the current bulkhead and adding a new (6' x 13') platform to the existing structures. A. C4 Gary Ange RECEIVED DCM WILMINGTON, NC KN MP -4 APPLICATION for Major Development Permit (last revised 12/27/06) North Carolina DIVISION OF COASTAL MANAGEMENT 1. Primary Applicant/ Landowner Information Business Name Agent/ Contractor 1: First Name V " -' Business Name Project Name (if applicable) Applicant 1�: First Name MI Last Name Mailing Address b-7 C,1, t !L n 'PI—. Applicant 2: First Name MI Last Name ZIP If additional applicants, please attach an additional page(s) with names listed. Phone No. 1 v'sJ3x/t, Mailing Address 7-0 5:- PO Box rl&vr State NG ZIP Country� j(OW Phone No. FAX No. `0YV\ I j1 7, - (�n J; ext. Street Address (if different from above) Cit r State ZIP Email t 2. Agent/Contractor Information Business Name Agent/ Contractor 1: First Name V " -' MI LastName \ Agent/ Contractor 2: First Name MI Last Nam Mailing Address b-7 C,1, t !L n 'PI—. PO Box City ��� States N ZIP Phone No. 1 v'sJ3x/t, Phone No. 2 ext. FAX No. Contractor # Street Address (if different from above) City State ZIP Email ay q— V-vL. L0M <Form continues on back> RECEIVED DCM WILMINGTON, NC Form DCM MP -1 (Page 2 of 4) 1 APPLICATION.for Major Development Permit 3. Project Locatfon Site Description County (can be multiple) Street Address � ` �f_ State Rd. # 0 nc("-w 7033- O — Subdivision Name City State Zip list) NWL (normal wa er vel) VNHW [:]NWL -4- (if many lot sizes, please attach additional page with a Phone No. e. Lot No.(s) (if many, attach additional page with list) ext. I I I I a. In which NC river basin is the project located? f. b. Name of body of water nearest to proposed project 4q4e g. <0 6 � 51 - _0 OAA & c. Is the water bo4 identified in (b) above, natural or manmade? d. Name the closest mijor water body to the proposed project site. XNatural []Manmade ElUnknown h. _ak Im 0 90"4 e- Is roposed work within city limits or planning jurisdiction? f. If applicable, list the Ianning jurisdiction or city limit the proposed Yes MNo r work falls within. A A 4. Site Description a. Total length of shoreline on the tract (ft.) b. Size of entire tractq.ft.) 0<-ee-T I c. Size of individual lot(s) d. Approximate elevation of tract above NHW (normal high water) or list) NWL (normal wa er vel) VNHW [:]NWL -4- (if many lot sizes, please attach additional page with a or e. Vegetation on tract f. Man-made features and uses now on tract .F g. Identify and describe the existing land uses adjacent to the proposed project site. h. How does local government zone the tr@.ct? i. Is the proposed project consistent with the applicable zoning? r (Attach zoning compliance certificate, if applicable) es []No [INA j. Is the proposed activity part of an urban waterfront redevelopment proposal? E]Yes No k. Has a professional archaeological assessment been done for the tract? If yes, attach a copy. []Yes ❑No NA If yes, by whom? - I. Is the proposed project located in a National Registered Historic District or does it involve a E]Yes 0No k101A National Register listed or eligible property? <Form continues on next page> RECEIVED DCM WILMINGTON, NC Foi" DCM MP -1 (Page 3 of 4) APPLICATION for Major Development Permit m. (i) Are there wetlands on the site? ❑Yes KNo (ii) Are there coastal wetlands on the site? ❑Yes KNo (iii) If yes to either (i) or (ii) above, has a delineation been conducted? ❑Yes []No (Attach documentation, if available) n. Describe existing wastewater treatment facilities. C. Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type o. Describe existing drinking water supply source. t -�7 ff d. p. Describe existing storm water management o treatment systems. e. 5. Activities and Impacts a. Will the project be for commercial, public, or private use? ❑Commercial ❑Public/Government rivate/Community b. Give a brief description of purpose, use, and daily operations of the project when complete. �114 110 1 "1 I C. Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type of equipment and where it is to be stored. _r , , t -�7 ff d. List all development activities you propose. e. Are the proposed activities maintenance of an existing project, new work, or both? Nip f. What is the approximate total disturbed land area resulting from the proposed project? 1100 Sq.Ft or ❑Acres g. Will the proposed project encroach on any public easement, public accessway or other area ❑Yes No ❑NA that the public has established use of? In. Describe location and type of existing and proposed discharges to waters of the state. i. Will wastewater or stormwater be discharged into a wetland? ❑Yes [-]No A If yes, will this discharged water be of the same salinity as the receiving water? []Yes ❑NoA j. Is there any mitigation proposed? ❑Yes ❑No A If yes, attach a mitigation proposal. RECEIVED <Form continues on back> DCM WILMINGTON, NC "�. ,- ,g r Form DCM MP -1 (Page 4 of 4) APPLICATION for Major Development Permit 6. Additional Information In addition to this completed application form, (MP-1)'the following items below, if applicable, must be submitted in order for the application package to be complete. Items (a) — (t) are always applicable to any major development application. Please consult the application instruction booklet on how to property prepare the required items below: a. A project narrative. b. An accurate, dated work plat (including plan view and cross-sectional drawings) drawn to scale. Please give the present status of the proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish between work completed and proposed. c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site. d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties. e. The appropriate application fee. Check or money order made payable to DENR. f. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in which to submit comments on the proposed project to the Division of Coastal Management. Name O V lS [v Phone No. Address (;p< y'Z-')_ Q VI �Vi WG Lq (;O 2[0 1 Name LAY✓ e� t✓,� jr Phone No. j ']� �/ Address 31 �ZI •� ��y"` `� ! `� ( T� ��I Name b Phone No. Address g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates. h. Signed consultant or agent authorization form, if applicable. i. Wetland delineation, if necessary. j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner) k. A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act. 7. Certification and Permission to Enter on Land I understand that any permit issued in response to this application will allow only the development described in the application. The project will be subject to the conditions and restrictions contained in the permit. I certify that I am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up monitoring of the project. I further certify that the information provided in this application is truthful to the best of my knowledge. Date 6 —���� Print Name L Signature VV Please indicate application attachments pertaining to your proposed project. ;WCM MP -2 Excavation and Fill Information ❑DCM MP -3 Upland Development ,tROCM MP -4 Structures Information ❑DCM MP -5 Bridges and Culverts „.., ��, .....,v. _� :,,� RECEIVED DCM WILMINGTON, NC Form DC • ,,;-2 EXCAVATION and FILL (Except for bridges and culverts) Attach this form to Joint Application for CAMA Major Permit, Form DCM MP -1. Be sure to complete all other sections of the Joint Application that relate to this proposed project. Please include all supplemental information. Describe below the purpose of proposed excavation and/or fill activities. All values should be given in feet. 1. EXCAVATIONhis section not applicable X a. Amount of material to be excavated from below NHW or NWL in b. Type of material to be excavated. cubic yards. c. (i) Does the area to be excavated include coastal wetlands/marsh (CW), submerged aquatic vegetation (SAV), shell bottom (SB), or other wetlands (WL)? If any boxes are checked, provide the number of square feet affected. ❑CW ❑SAV ❑SB OWL ❑None (ii) Describe the purpose of the excavation in these areas: 2. DISPOSAL OF EXCAVATED MATERIAL a. Location of disposal area. C. (i) Do you claim We to disposal area? ❑Yes ❑No ❑NA (ii) If no, attach a letter granting permission from the owner. e. (i) Does the disposal area include any coastal wetlands/marsh (CW), submerged aquatic vegetation (SAV), shell bottom (SB), or other wetlands (WL)? If any boxes are checked, provide the number of square feet affected. ❑CW ❑SAV MSB OWL ❑None (ii) Describe the purpose of disposal in these areas: d. High -ground excavation in cubic yards. %Whis section not applicable b. Dimensions of disposal area. IF IN d. (i) Will a disposal area be available for future maintenance? []Yes ❑No ❑NA (ii) If yes, where? f. (i) Does the disposal include any area in the water? ❑Yes ❑No [INA (ii) If yes, how much water area is affected? RECEIVED DCM WILMINGTON, NC Access Other Channel (NLW or Canal Boat Basin Boat Ramp Rock Groin Rock Breakwater (excluding shoreline NWL) stabilization) Length Width s Avg. Existing NA NA Depth Final Project NA NA D Depth 1. EXCAVATIONhis section not applicable X a. Amount of material to be excavated from below NHW or NWL in b. Type of material to be excavated. cubic yards. c. (i) Does the area to be excavated include coastal wetlands/marsh (CW), submerged aquatic vegetation (SAV), shell bottom (SB), or other wetlands (WL)? If any boxes are checked, provide the number of square feet affected. ❑CW ❑SAV ❑SB OWL ❑None (ii) Describe the purpose of the excavation in these areas: 2. DISPOSAL OF EXCAVATED MATERIAL a. Location of disposal area. C. (i) Do you claim We to disposal area? ❑Yes ❑No ❑NA (ii) If no, attach a letter granting permission from the owner. e. (i) Does the disposal area include any coastal wetlands/marsh (CW), submerged aquatic vegetation (SAV), shell bottom (SB), or other wetlands (WL)? If any boxes are checked, provide the number of square feet affected. ❑CW ❑SAV MSB OWL ❑None (ii) Describe the purpose of disposal in these areas: d. High -ground excavation in cubic yards. %Whis section not applicable b. Dimensions of disposal area. IF IN d. (i) Will a disposal area be available for future maintenance? []Yes ❑No ❑NA (ii) If yes, where? f. (i) Does the disposal include any area in the water? ❑Yes ❑No [INA (ii) If yes, how much water area is affected? RECEIVED DCM WILMINGTON, NC 3. SHORELINE STABILIZATION (If development is a wood groin, use MP -4 — Structures) a. XBulkhead Typpe of shoreline stabilization: ❑Riprap ❑Breakwater/Sill ❑Other: c. Average distance waterwardNHW r NWL: a� e. Type of stabilization material: g. Number of square feet of fill to be placed below water level Bulkhead backfill G50 Riprap Breakwater/Sill Other i. Source of fill material. I-ok 16, E] This section not applicable b. Length: J.7— Width: ZWidth: -�4A d. Maximum distance waterward NH or NWL: , lot f. (i) Has there been shoreline erosion during preceding 12 months? ❑Yes `0 ❑NA (ii) If yes, state mount of erosion and source of erosion amount information. h. Type of fill material. 4. OTHER FILL ACTIVITIES E] This section not applicable (Excluding Shoreline Stabilization) a. (i) Will fill material be brought to the site? es ❑No ❑NA b. (i) Will fill material be placed in coastal wetlands/marsh (CW), If yes, submerged aquatic vegetation (SAV), shell bottom (SB), or {ii) Amount of material to be placed in the water �j other wetlands (WL)? If any boxes are checked, provide the number of square feet affected. (iii) Dimensions of fill area —Lei f.< 57:r, y []CW ❑SAV ❑SB (iv) Purpose of fill❑ t WL one (ii) Describe the purpose of the fill in these areas: 5. GENERAL a. How will excavated or fill material be kept on site and erosion b. What type of construction equipment will be used (e.g., dragline, controlled? _ backhoe, or hydraulic dredge)? r t G�-! c. (i) Will navioonal aids be required as a result of the project? ❑Yes o ❑NA (ii) If yes, exp Kin what type and how they will be implemented. d. (i) Will wetlands be 9cossed in transporting equipment to project site? ❑Yes WNo ❑NA (ii) If yes, explain fteas that will be taken to avoid or minimize environmental impacts. i Form DC _ , STRUCTURES (Construction within Public Trust Areas) Attach this form to Joint Application for CAMA Major Permit, Form DCM MP -1. Be sure to complete all other sections of the Joint Application that relate to this proposed project. Please include all supplemental information. 9. DOCKING FACILITY/MARINA CHARACTERISTICS ❑This section not applicable a. (i) Is the docking facility/marina: b. (i) Will the facility be open to the general public? ❑Commercial ❑Public/Government rivate/Community ❑Yes AO c. (i) Dock(s) and/or pier(s) d. (i) Are Finger Piers included? ❑Yes ❑No (ii) Number If yes: (iii) Length (ii) Number (iv) Width (iii) Length (v) Floating ❑Yes ❑No (iv) Width (v) Floating ❑Yes ❑No e. (i) Are Platforms included? ks [-]No If yes: (ii) Number (iii) Length (iv) Width 1�! (v) Floating ❑Yes XNo Note: Roofed areas are calculated from dripline dimensions. g. (i) Number of slips proposed (ii) Number of slips existing i. Check the proposed type of siting: ❑ Land cut and access channel ❑Open water; dredging for basin and/or channel []Open water; no dredging required ❑Other; please describe: k. Typical boat length: m. (i) Will the facility have tie pilings? ❑Yes ❑No (ii) If yes number of tie pilings? f. (i) Are Boatlifts included? ❑Yes ❑No If yes: (ii) Number (iii) Length (iv) Width h. Check all the types of services to be provided. ❑ Full service, including travel lift and/or rail, repair or maintenance service ❑ Dockage, fuel, and marine supplies ❑ Dockage ("wet slips') only, number of slips: ❑ Dry storage; number of boats: ❑ Boat ramp(s); number of boat ramps: ❑ Other, please describe: j. Describe the typical boats to be served (e.g., open runabout, charter boats, sail boats, mixed types). I. (i) Will the facility be open to the general public? []Yes ❑No RECEIVED DCM WILMINGTON, NC s,tf'.. Z. DOCKING FACILITY/MARINA OPERATIONS a. Check each of the following sanitary facilities that will be included in the proposed project. ❑ Office Toilets ❑ Toilets for patrons; Number: ; Location: ❑ Showers ❑ Boatholding tank pumpout; Give type and location: b. Describe treatment type and disposal location for all sanitary wastewater. his section not applicable c. Describe the disposal of solid waste, fish offal and trash. d. How will overboard discharge of sewage from boats be controlled? e. (i) Give the location and number of "No Sewage Discharge' signs proposed. (ii) Give the location and number of "Pumpout Available" signs proposed. f. Describe the special design, if applicable, for containing industrial type pollutants, such as paint, sandblasting waste and petroleum products. g. Where will residue from vessel maintenance be disposed of? h. Give the number of channel markers and "No Wake" signs proposed. i. Give the location of fuel -handling facilities, and describe the safety measures planned to protect area water quality. j. What will be the marina policy on overnight and live -aboard dockage? k. Describe design measures that promote boat basin flushing? I. If this project is an expansion of an existing marina, what types of services are currently provided? RECEIVED CCM WILMINGTON, NC r , I m. Is the marina/docking facility proposed within a primary or secondary nursery area? ❑Yes ❑No n. Is the marina/docking facility proposed within or adjacent to any shellfish harvesting area? ❑Yes ❑No o. Is the marina/docking facility proposed within or adjacent to coastal wetlands/marsh (CW), submerged aquatic vegetation (SAV), shell bottom (SB), or other wetlands (WL)? If any boxes are checked, provide the number of square feet affected. ❑CW ❑SAV OSB OWL ❑None p. Is the proposed marina/docking facility located within or within close proximity to any shellfish leases? ❑Yes ❑No If yes, give the name and address of the leaseholder(s), and give the proximity to the lease. 3. BOATHOUSE (including covered tiffs) ,This section not applicable a. (i) Is the boathouse structure(s): ❑Commercial ❑Public/Government ❑Private/Community (ii) Number (iii) Length (iv) Width Note: Roofed areas are calculated from dripline dimensions. 4. GROIN (e.g., wood, sheetpile, etc. if a rock groin, use MP -2, Excavation and Fill.) his section not applicable a. (i) Number (ii) Length (iii) Width 5. BREAKWATER (e.g., wood, sheetpile, etc.) This section not applicable a. Length c. Maximum distance beyond NHW, NWL or wetlands b. Average distance from NHW, NWL, or 6. MOORING PILINGS and BUOYS )(rThis section not applicable a. Is the structure(s): ❑Commercial ❑Public/Government ❑Private/Community c. Distance to be placed beyond shoreline Note: This should be measured from marsh edge, if present. e. Arc of the swing b. Number d. Description of buoy (color, inscription, size, anchor, etc.) RECEIVED DCM WILMINGTON, NC '-y.:im - - (Struc$. res Pari. 4 A -1) 7. GENERAL a. Proximity of struc(s) to djacent riparian property lines 10, ur I,I Note: For buoy or mooring piling, use arc of swing including length of vessel. eater body i e. (i) Will nav conal aids be required as a result of the project? ❑Yesexplain No ❑NA (ii) If es x ain what type and how they will be implemented. 8. OTHER a. Give complete description: a b. Proximity of struct e(s) to adjacent docking facilities. d. Waterpiepth at waterward end of structure at NLW or NWL Date �rc�— PCC vtANZ4� Project Name (77Av-4 r-Mv f\'im Applicant Nam Applicant Signature section not applicable RECEIVED DCM WILMINGTON, NC �W(�-t r , 17 ,< DOJt �(-A l("5 ; -7 0-bX 70 G�-� 05:4-t C 52��61 1h = P/U w (3v,5 -- p mloo" -F�l (