42874D - Upchurch

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4'DAMA/ DREDGE & FILL i
3ENERAL PERMIT Previous permit#
few Modification nlComplete Reissue Partial Reissue Date previous permit issued
rized by the State of North Carolina, Department of Environment and Natural Resources ,.
:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC -7M, !ZOO
�/ ''� �) ,,/,� ❑/Rules attached.
t Name t��t4/S Y e' J: !/FAO✓(_t Project Location: County Afit/fPr �v,
i34S 1�/kh” l_.jin 'lam /Zt Street Address/State Road/Lot#(s)
401104t''tBI Statee-ZIP z454if3
(//0 ) 724 -OM Fax#( ) Subdivision
ed Agent City _ ZIP
Ocw YEW =',P1A CAS ❑PTS Phone# ( ) - ' 1 River Basin Zefri
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C PWS: ❑FC:
T / no PNA t9 no Crit.Hab. (P/ no Closest Maj.Wtr. Body IP' vl
'Project/Activity Propane I pI t r - 1044-14 rfrA
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ier(s) 4100 V" /2'y, s
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e Length 73 ,7
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yes (t'�. 13 6 k'k/�S l jj i Ntb / LA,
kttached: yes
ng permit may be required by: 149.1[XPr ii,, See note on back regarding River Basin r

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Tame of Individual Applying For Permit: C 1-(A O LE Of C 1-AU
C�
iddress of Property: k3+-15 K I N)Gs CAI i91 nJ G- RV, A-V/YyST C,9 p,p.\ C. /8'143
(Lot or Street #, Street or Road)
C4AIW ST ,A1) , N C PE I'DcR Covof t'/
(City and County)
hereby certify that I own property adjacent to the above-referenced property. The individu
pplying for this permit has described to me as shown on the attached drawing the development thf
re proposing. A description or drawing., with dimensions, should be provided with this letter.
I have no objections to this proposal.
you have objections to what is being proposed, please write the Division of Coast:
Ianagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-390
ithin 10 days of receipt of this notice. No response is considered the same as no objection
Du have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be sE
ck a minimum distance of 15' from my area of riparian access - unless waived by me. (If yo
ish 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.
gn N me Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
\Tame of Individual Applying For Permit: C: l-1 A t_C S 5, U P C U R C t-I
kddress of Property: 13 H S RI,I1GS LArlDtrh G 20. t{A M P sTEA 0 Nl C- 18L1&t
(Lot or Street #, Street or Road)
1-\ A/APSTCA0 , 1\ c , PE \ 1 R co °iq
(City and County)
hereby certify that I own property adjacent to the above-referenced property. The individu
.pplying for this permit has described to me as shown on the attached drawing the development th
re proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
f you have objections to what is being proposed, please write the Division of Coast
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-39(
vithin 10 days of receipt of this notice. No response is considered the same as no objection
ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be s
ck a minimum distance of 15' from my area of riparian access - unless waived by me. (Ifya
'ish 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.
/(1/14/4Name / D to
I Lam'n� ^ /

Bank of America Advantage'
CHARLES J. UPCHURCH 5578
347 SABRA DR.
WILMINGTON,NC 28405 66-19/530 NC
392-6556
Date k k - k 7- 0 r 1858
Pay \ cJ
to"theorderrY,..Pc_ tu-Ar--t,LS—S (1-4
ef'4X0 0 -oz÷:
1 �Q,"'
Bank of America Dollars 8
:00'0.0.
ACH R/T 053000196
Memo 2.� �T` _ C'AAA CaY/11-1.
1:0 5 3000 19 6': 000 18 3 E08 6 2 LH'
SE 7
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