79965D - Burch

0 _ CAMA / - DREDGE & FILL N9 79965 A B C (61,
GENERAL PERMIT Previous permit#
>�-= ❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality I //� �
and the Coastal Resources Commission in an area of environmental concern pursuant to ISA NCAC (4-H•2.0.:��—''
E Rules attached.
Applicant Name _4.5 --- (...)--(-C Project Location: County J\ ,JCL .) .- \c,, c- r
Address'' �all ii- ��W �--�`. Street Address/State Road/Lot#(s)
City l�J 1 I n^S Tc •IN State L ZIP 10{C L-Th I"\f AL
Phone# (q10 ) Sao 5E I8 E-Mail Subdivision Authorized Agent (4 i 1-,S 40,^ City 1)i1 W
. `+l-k0_ �y 1l ZIP -F 7C%c�
Affected ❑Cw i)gEW IOTA DES ❑PTS Phone# ( ) River Basin C.- .P.C.- .P....
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body (nat /(nan /unkr
ORW: yes / no PNA y--
es / no Closest Maj.Wtr. Body 1 IJ-M)
Type of Project/Activity -4- ':')1< .:> ( (I4T (A '--rc �n t ce Ql` iNl1`-)
— it.8 dock ' 1 I`` (Scale: Vt 7 r )
Pier(dock)length
Fixed Platform(s) j
1 ! I 1
Floating Platform(s) I j I
Finger pier(s) Milli ill" _..�—
Ifil
I Groin!engirt'
II
! y
number -I ....... !...
i
: :Le
raengthi11 jIIasin,channel
I
i
cubic yards � 1
Boat ramp //_ 11111
. .. .•.....{.. .1 {. �1,.1� I I Emil Nu. HIM
Beach,Bulldozing pJIpii
lIHium.. ii.�
., , i
Other . I� I
_. _ �11!.........,,...........ii" I II
oilmmorik owl
,._,,,,,
„--, ,
Shoreline Length / 5 gill"
HIHIflHIIUI
A L 1
SAV: not sure yes -0,
IT
Moratorium: n/a yes nil! ■ ' I i 112 III 1 _... o jPhotos: 2 I m yes no • ��� �....... EEL . UPI `._ ---
Waiver Attached: yes no ! ,
A building permit may be required by: Kati,.) v0-CV (G-1.) r U See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)A 1 ` L
Notes/Special Conditions f� e�' g ate- �oc ZQ,4. �Lcf (,,_x ( (1.C�T c.c..e2
-eX (Si l Y;n-t--L.c-t4e(U yc .
Cxq`If),\. ,c\ic— 5127121
Agent or Applicant Printed Name Permi ' PrinteckName 4543Q
Signature **Please read compliance statement on back of permit** Signature i I

V.CAMA/ CI DREDGE & FILL 7996 A B C t
i-ii-o
GENERAL PERMIT Previous permit#
New 1Modi iication ❑Complete Reissue CJPartial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality ,,qqy�]
and the Costal Resources Commission in an area of environmental concern pursuant to ISA NCAC t...>t tl
`_ 0 attached.
Applicant Name ` 5�" ,.CC r` __ Project Location: County__r r.4O,�*
Address', }}g IZ �I. V rel�+t� b r Street Address/State Road/Lot#(s) .
City ( d M 1C).#• State YQ<- ZIP 2.-13 c.1ekf E-
Phone#( ) QcfQ 5$a E-Mail Subdivisiontt '� --
Authorized Agent _C eR City W t-1fi0.t..c ZIP ZE 3/(0'
Affected ❑CW '40TA DES OPTS Phone# ( ) River Basin K
s D OEA O HHF D IFI D URA D WA
AEC : Adj.Wtr.
d PWS: Body 641141 cLO (wrist /unkn)
PNA , no
Closest Maj.Wtr.Body ` I •*IA.)
ORW: yes /
Type of Project[Activity t 1 a\ ej
�.e.a aq.k e r : t-rr )
+• (dock)length _ _ .-�. -_ �_
, .
Fix:.Platforms) i ` ._t i f
Float Platform(s) a 1 ��� • _ , ..Q
r- t
Finger pi s)_ • — _ II 11i
ai
Groin den: l
number --«- --- _, _ _
'
Bulkhead/Ri. ..length - '- ,
avg distance J., -1
1 �
II
rnax distance o { 'LL1 I i
Basin,channel { -. —.--1_.-.
1 - illiiilirni:i",___ ,
cubic yards ��
t
r
it,
Boat ramp { y i j w ''. t
i
._
' �
F _...._
Boathouse/ - _.._. . - - - - .
_ ,
_.„irs7,,iiiaatt_e
B Bulldozing s:: i�in �s -, , , ,
Other
Shoreline Length 1f J i I Li $ U RU �U ',�V+ .
SAV: not sure yes }v .� I , . . es. _ wan.
i
i
Moratorium: n/a yes i>ei) . 4. Ow ` .. . `,-p i ��
Photos: yes 6) , r __ _ . t' ' w= Ilii -1 C . .- _) t { --i --i.._
waiver Attached: yes 6' " "'f : t 1 i
A building permit may be required by: k i't "CY (i../t)'t41/41 See note on back regarding River Basin rules,,
(Note Local Planning Jurisdiitionsction)_ )� 5 1110 L o- l r i 1 k- �"}G
Notes/Special Conditions 1w �� �� n-� i t�3r IlC?
teck
A, )
yP,,c-- '4.-� T}f i�L LL ' {tf
..3arn,S 0, G,rcL rEV-1Av Gl
Agent or Applicant-Printed Name P ' Prim Name
..4../
Please read compliance statement on back of permit" Signature ,
0-1(C. Sfr 7-1 ZA "94Z4 .1___.
Ap kation Fee(s) Check# Issuing Date Expiration

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: �m[S (1• 64WL
Address of Property: g/a 1/few Dr Q LJ
— (rM� . New / #."
(Lot or Street#, Street or Road, City 8,County)
Agent's Name#: j 1E?(e f. :rt4u_— Mailing Address: 8 eat
Agent's phone#: [phone] . 4o4 y W i 1 rw'ns NL clmo'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 drawing, with dimensions, must be provided with this letter.
VI 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 Management(DCM)in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at(910) 796-7215.No response is
considered the same as no objection if you have been notified by Certified Mall.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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.
(Property Owner
(Information) (Adjacent Property,� wner Inf o )
•. c(�• 4
'gn'lure Si nature
IV/
.>'++eS Q • .sore, law+ aeaN f 447--)
Pant or Type Name Print or Type Name 1
14L . h{o •• V e w il7r; �/ ->�-✓/c7( P v.
failing Address Mailing Address
tA :IIK.nION d- 401 !/V rl / 7��-- A/C z 0 q el,
City/State/Pfp City/State/Zip /
Clio ' qa sggJ G7'/0 3(0. ' c? 7yz
Telephone Number Telephone Number
$ "1 (-2CZ/
Date Date
Revised 6/18/2012

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to rH-es Q - t 4,ti . 's
(Name of Property Owner)
property located at Yt2 7 Ji1- tJ, w
(Address, Lot, Block; Road, etc.)
on , in (,U t Irrl Igo— , N.C.
(Waterbody) (Ci own and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach �a site drawing)
,DOCk. 57//4.y 5 A- 5 — l S /V d tom' v ca�
ACf)Iac7e t, 5V- �oa1- /tea f,561(Pkd- 7:Li
•
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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.
(Property Owner Information) (Adjace ;lefty Owner In ation)
tgn urel O, IC S i4(.. /47.71106 644—,
Print or Type Name Print or Type Name
Zi), 1..1 e V:e tD,w- (14. �7.42l
Mailing Address Mailing Addretvi 1 9'
City/Stateip City/State/Zip
47i0 qYQ sf31e 1/0 G g 971Z
Telepho a Number Telepho Nu ber )
Sfir �o,l 1 �— 2 Q2
Date Date
(Revised 6/18/2012)

U.S. Postal Service"'
CERTIFIED MAIL RECEIPT
��STA��� Domestic Mail Only
� '`//��ss c� {{jj////�� Q� For 'C.I,very rttorth?bon visit our evebsite at t7P:c,uspS.corn
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ul
FAISON D certified Mae Fee $ .60 U
110 E MAIN ST -° $ tz.BS 0341
FAISON, NC 28341-8900 f` Fxtre$e oes&FeesidaYrbax,aiYroealknsliW) 02
[phone] o 01.1.uxr,R.o4tmsdWvm $ 30.00
05/17/2021 09:48 AM o ORatu �.nRoceipt(ds-bd.) $ postmark
0 p Certified Mail Reerlcted Dedvsy $ SO.00 Here
Product 0ty Unit Price o ti �� $ $n-00
Price o Postage $U.55
First-Class Mail® 1 tm $ 05/17/2021
$0.55 rrt Total postage and Fs.Ott
Letter
Raleigh, NC 27615 -0 Sent To
Weight: 0 lb 0.80 oz ra
Estimated Delivery Date DSheerarilApfWic7.ofge ffortfo,
r`
Thu05/20/2021 -""--".-_-_._._...______.........__-_-.
Certified Mails $3.60 'crti, tale,2IP+-4+""'""'""'"""'"""'""
Tracking #: pSForm5:ii:�Apri4-0 ,.., Sc k:::cr,.e for'nr,tr,xt;one,
70163560000076059108
Return Receipt $2.85
Tracking #:
9590 9402 4911 9032 1467 03
Affixed Postage -$0,55
Affixed Amount: $0.55
Total $6.45
Grand Total: $6.45
Debit Card Remitted $6.45 .
Card Name: VISA
Account #: XXXXXXXXXXXX7429
Approval #: 868765
Transaction #: 349
Receipt #: 010091 .,
Debit Card Purchase: $6.45
AID: A0000000980840 Chip
AL: US DEBIT
PIN: Verified t
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Check
Date Received Date Deposited Check From(Name) Name of Permit Holder Vendor Check number_ amount Permit Number/Comments Receipt or Refund/Reallocated
Columnl Column2 Column3 _ Column4 Column8 Column6 Column7 Columns Column➢
5/272021 Christopher Morrison Const. 'Chris and Stacie Morrison First National Bank 1607 $ 600.00:GP#80106D PA mt.12783
5272021 Tyler B Cook same Fidelity Bank 3110 $ 600.00 GP#801070 PA rd.12785
5/27/2021 C Guy Sorrell Jr. same Bank of America 5060 $ 200.00 GP#801520 PA rcL 12784
5272021 Duncan Marine Contractors,Inc. Vance Neal Branch Banking and Trust 8381 $ 400.00 GP#80131D KE rd.13444
5272021 James 0 Burch same PNC Bank 846 $ 200.00 GP#79965D BH rct.12896
_..
5/27/2021 Christina Grifaldo Jamie Grifaldo Coastal Bank and Trust 1094 $ 200.00 GP#79920D _ _ JD M.14145
5/27/2021 Adam Tawas same BB&T 7273 $ 200.00 GP#79921D JD rct.14146
5/27/2021 Boat List Specialist LLC Rick and Dana Benner i BB&T 2000 $ 200.00 GP#79987D PA rct.12780
5/27/2021 Joey R Floyd PA same First Citizens Bank 2131 $ 200.00 GP#79919D JD rct.14144 __
5/27/2021 F 8 S Marne Contractors Inc. Dave Anna First Bank 1020 $ 200.00 GP#79991D KE rot.13445 __
5/27/2021 H5 Construction,LLC Matt&Merritt Hon BB&T 2612 $ 200.00 GP#71772D BB rot.14935
5272021_ Grice Construction Matthew and Rebecca Ward BB&T 14566 $ 200.00 GP#80269D BB rct.12999
5/27/2021 Custom Design Marine,Inc. Jack Rector First Federal 1381 $ 200.00 GP#79948D B8 rct.14933