51511_VANCE, GARLAND_20071001

-: ❑ CAmA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
❑New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources r� f} ^'
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / " H '. V U"
0 Rules attached.
Applicant Name '� t ,i '� Project Location: County
Address
City State
Phone # O ` - Fax #
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA
❑ PWS: ❑ FC:
ZIP
❑ PTS
❑ N/A
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # O River Basin
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Agent or.Applicant Prihted Name
Signature PI a ead compliance statement on back of permit"
Application Fee(s) Check #
PermitOff er's Signature
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888-4RCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

Refund fnr client
Subject: Refund for client
From: Ronda Bennett <[e-mail]>
Date: Thu, 27 Sep 2007 08:16:28 -0400
To: Melissa Sebastian <[e-mail]>
Melissa, we have a client that needs a refund of $200.00 where he overpaid permit
fee for GP51511. His info is as follows:
Garland Vance, 9625 Mendota Rd., Abingdon, VA 24210. His SS## is 262-15-7244. Let
me know if you need anything else. 'thanks
1 of 1 12/13/2007 8:15 AM

CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER
FORM
Name of individual applying for the permit: C a e to N � V 0 N C �-
Address of property: �LAL11. Uy e
(Lot or street#, street of roo
O O N) 'c _
�— (City & C
q 5/ 5
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, should be provided with this letter.
r)w, X I have no objections to this proposal
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Ave., Morehead City, NC 28557 or call [phone]
within 10 days of receipt of the notice. 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
sandbags 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
I do not wish to waive the 15' setback requirement
Signature Dat
Print Name
Telephone number with area code

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER
FORM
Name of individual applying for the permit:
on(-, (0 N d V o t/ c'-e
Address of property: 0\ V e- C P �� ,� 6 I \] t�—'
(Lot or street#{, street of road)
0
NC e BSI
(City & County)
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, should be provided with this letter.
ZI have no objections to this proposal
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Ave., Morehead City, NC 28557 or call [phone]
within 10 days of receipt of the notice. 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
sandbags 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.)
V I do wish to waive the 15' setback requirement
I do not wish to waive the 15' setback requirement
ita- L L--) .
" 4 =Q
ignature Ooo-DAP-b
DateC. J .
Printt Name ame
TIq - aoa- !!a9
Telephone number with area code

Refund -for client
Subject: Refund for client
From: Ronda Bennett <[e-mail]>
Date: Thu, 27 Sep 2007 08:16:28 -0400
To: Melissa Sebastian <[e-mail]>
Melissa, we have a client that needs a refund of $200.00 where he overpaid permit
fee for GP51511. His info is as follows:
Garland Vance, 9625 Mendota Rd., Abingdon, VA 24210. His SS# is 262-15-7244. Let
me know if you need anything else. Thanks
1 of 1 9/27/2007 8:17 AM

GARLAND VANCE JR
LINDA :DENISE VANCE
PH 276-628-6680
9625 MENDOTA ROAD
ABLNGDO , VA 24210-4155
Pay to the V
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HIGHLANDS UNION BANK
Abingdon, Banner Elk, Blountville, Boone,
i3ristol, Glade, Marion & Rogersville
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