77611D - Goubran

Check
Date Received Date Deposited Check From(Name) Name of Permit Holder Vendor Check Number amount Permit Number/Comments Receipt or Rerund/Reallocetad
Columnt Column2 Coumn3 Column/ Columns Column6 Cdumn7 Column8 Column')
10/21/2020 Laura E Adams Laura and Robert Adams USAA Federal Savings Bank 446 § 200.00 GP#76539D PA itt.10274
10/21/2020 B&B Coastal Construction Corp. Clear Skies LLC Go Charlie Connor Wells Fargo Bank 5009 $ 400.00 GP#77642D Tmac rct.11810
10/21/2020 B&B Coastal Construction Cam, Martha Spence _ •Welts Fargo Bank 5010 $ 400.00 GP#77643D Tmac rd.11809
10/21/2020 Ronald M.Ake same SunTrust 1393 $ 600.00 GP#76439D Ben rd.11713
10/21/2020 D.Teeters&Associates LLC James Todd Williams First National Bank 2638 $ 200.00 GP#73584D JD rut.11752
10/21/2020 Lighthouse Marine Construction Inc. William Fred Taylor Coastal Bank and Trust 3426 $ 400.00 GP#73583D JD rd.11753
10/21/2020 Jerry Ennett Bruce and Patsy Jones Coastal Bank and Trust — 3365,$ 200.00 GP#73582D JD rd.11754
10/21/2020 !Clements Marine Construction Edgewater HOA FCB 5506',$ 400.00 GP#765650 KE rot.10799 _.
10/21/2020 F and S Marine Contractors Inc. Joe Elphick _ PNC Bank 8863 $ 200.00 GP#77881 D KE rd.10800
10/21/2020 Southern NC Marine LLC Shane Moran,Mark Nullities,James Ga First Bank 1336 $ 200.00 GP#7.580D JD rot.11758
10/21/2020 Challie Minton same State Employees CU 1908 $ 400.00 GP#718800 JD rot.11858
10/21/2020. Willie Clarence Richardson/Richardson Construe'Todd Schad BB&T 7808 $ 200.00 GP#718950 Ben rd.11716 _.
10/21/2020 Southern NC Marine LLC David Gamer First Bank 1337.$ 200,00 GP#73581D JD rut.11755
10/21/2020 Pyramid Engineering.Inc ISidney Keith Craig BB&T 13330'$ 600.00'GP#77613D _ - Ben rct.11714
10/21/2020 Mark Castor •same FCB 12272 $ 200.00 IGP#73579D JD rd.11757
10/21/2020 _ McPherson Marine Services.LLC Ashley Rudolph FCB 3581 $ 200.00''GP#77610D Ben rd.11718
10/21/2020 F and S Marine Contractors Inc. Eric Rosenberg PNCBank 8882 $ 200.00 GP#77882D .KE rct.12401
10/21/2020 Carolina Development and Properties Michael Goubran Jr. PNCBank 2911 $ 200 00 GP#77611D Ben rct.11719

1 . ,
\.
CAMA/ DREDGE & FILL
INC 7 76 C
GENERAL PERMIT Previous permtt
New Modification Complete Reissue )(Partial Reissue / H
it \
( 3 4.1,B
Date previous permit issued Vii.a/2
As authonzed by the State of North Carolina.Department of Envtronmental Quality2-°()
and the Coasul Resources Commesion in an area 011111AVCOrnerstal concern pursuant to ISA NCAC
Rules staidett
Applicant Name M 1 C-1`"1 G`'.4jura-K 3r ' Protect Location: County i3. KO
Address An C ,..reit,4-.
_ Street Address/State Road/Lot*(s)
City flea-t1.41._ _._.,stateSc. ZIP ckl 0 11.1 criaC,stOr,_ _
...... __..........
Phone#(764) *PT°I -Ill WI E-Mail , ClirvISsibdivision
Authorized Agent ......----- CitY 1-1.44ve-, . vi.._._______ ZIP 9 Licl 1..
cw N EW "‘ TA ISPTS
Affected Phone# ( . ___ River Basin i "°••140.-
OEA W IN USA N A
AECIS) N Ad1 Wtr,Body 64.V.I. A G !N.II.L.ehrligi
PWS
, ii•-•k......)
Closest Mai Wtr Body- i ,
iIk
ORW yes ,4,:wo) PNA yes /glIP
Type of Project Activity ReJFIACe c:X e_ri de cY-- aid adick rc,oic ,
(Scale: 14 l'-'-2.0 )
Per;dock)length —
r-
rr-
needPlatiormtl 1 2:"if t(Si.. . ._-.... . .
- 1 I
%sung Pladonsysi ' 1
•
1 1 .
Green pith _—.1- . -
__— -_ _ _____...-
"
number ....
--- ,--r - i ---' • .i ---------•-'"--------4- i--- - - -- : -4 .......)
. 1
Bulkhead Lora()length ......
_
....—
avg*stance -
4--EV-7"
oboe 1 I l%T--
E. ,.i.
faoat hra_a_Amuk,_Cp___)Bd14a .
oat oatf/ „.,
eteda_am
, - — 14r--"-j-ke"7-
--
Oise — f .
4
roaPA 4edeck- _ t0.5
L--'-1Ff-
----.--S—I
44-
)1IG
Shaming Logo%.__.7 S. . ..
& )r et_
,,,.: ,..,
03 ,ci.vOf 4.0\ Or•
1
Morsexeset E) ref et) n 1 .
7401/4K PhOtOS" l'es ) leprisrearif _
-.--
Warier Aearbed yes no
See note back regard%River Basin rules.
A building permit may be ftclueed by 1°`""- QC- 1+1A-luv' fe-c`''''It' on
(Note Local Planning junschcoon)
re
lo oc- 7H. - o Ilk c cilSigt. D-k cit 1 lAt°kw"f cspfl .
Notes/Special Conditions A.tt f tr, Lab
,
6;411'CJ1 4/ Z C4A - C" 1 till=
otz7Xinteistiiiii. T'Sranwit
@- - c ---
g Oa, CO 4,1111 Ibills3/2,0zo ,.//'324.20_
Wig Explosion-

k )/NCAMA / . DREDGE & FILL N9 66363 A B C a
_nE iFRAL PERMIT Previous permit#
�' slew Modification —:Complete Reissue .Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environment and Natural Resources u `
and the Coastal Resources Commission in an area of environmental concern pursuant to ISA NCAC 01 ` 1 , 1.00 • •I
M'��`',1� i ❑Rules attached.
Applicant Name-7 I k� 1 (7o V WAh �t. Project Location: County g r
Address t 1 /1�0P1 1\I e\I .e, 6-}. Street Address/State Road/Lot#(s)
City itiN - 1 , State S C zip 1113 0 11; S vJ-o rl c-IS VA t(. t cL ,v (,l
Phone#(ZDy) U 1— QUOi;E-Mail Subdivision
Authorized Agent City i+0 6(-At h ZIP 1(Q—
Affected 0 CW Xr'A DES ❑PTS Phone ("" ) River Basin LAP/A
❑OEA 0 HHF ❑IH ❑UBA O N/A r
I qFr `s); W Adj.Wtr. Body __—L�VIA ) A (nat unkn
PS: VV
ARW yes ( � PNA yes / Closest Maj.Wtr. Body_._------- --- Al V v/_.-
1 Tyne of Project/Activity �P\� Q.Ic,c'6�V CIO C c Vt V1 k F 1``-1 °.v A,i 1 �`v.6 k`'
ir- - 1 1 -
VtA .) to oa..t1'4-, CoN-e,✓' c. Pi`01- v r"'l• (Scale: k . lot
Pier(dock)length
I Fixed Platform « /�,s) , v 1 (CD"c"141)•- -• . _ .
fFloating Platform(s) g r X I til 1 ! i
1 Finger pier(s) f_._ . j ;
Groin length - .__- -
i number
t _ -, , - •
IBulkhead/Riprap len • _ l I -
avg distance shore [ {1t �� f/ !�
max d• a offshore 1]_ • 7 `l, � at I - . -- - ; i i 4 ,
1
i Basin,than n�(1� /� -_ {. - . t .
y�
Boat ramp
' 60 at h°USW@ 1 3 i 3 I -- .-.► --
Beach Bul • lqA f .4 - -_ -
:10041+-1-
Other 4GtivK P X UV 0 � —..- - i
/ . t 1.0.51. �� •
Shoreline Length ,5 -- -
SAV: not suresureYes
6 1 ._. ._ i _._ _ a
r. . . _ . - -
14 i � i
Moratorium: n/a yes 1 L., W 0�p1
Photos: yes >o . .__ I
cur a. -T'~
Waiver Attached: 0 no - - --- -- - - --- ------------_- --- - -----------------__—
A building permit may be required by: TO',',An 0 07 \IGO t ekt k\• ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) } 07 n r G 11 S L ` �,
1 Notes/Special Conditions P'"V k'C.s kI - Roil A 0 , \ 0- "-vt t oCc `- 1rA I-L 1
I a vi ct c-c, \ (-trio t a1-1-auk..S cil 7 t_, M o�.�C.vIko J✓N o cti� d..31�Att, = 4,s `
f l ik. 6 0-1'a-A Se A.+V'- f ok i I
Agent or Applicant Printed N PermitOAOfficer' • ted e
"#Pleas read corn • ._ statement on back of permit" Signature
100. 00 __11/1 olit_kal.ptk_
. Application Fee(s) check# Issuing Da c• 'ration e

DocuSign Envelope ID 4FBDEA07-D19E-4085-9AA8-514886FFC00F
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Michel Z Goubran Jr 's
(Name of Property Owner)
property located at 113 Swordfish Dr,
(Address, Lot, Block, Road, etc.)
on Inland Canal , in Holden Beach , N.C.
(Waterbody) (City/Town and/or County)
?I-iesapplicant has described to me, as shown below, the development proposed at the above
loon.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
We propose to rebuild the existing dock, not to exceed 400sgft approx 12x16
and add a roof .
The existing dock will remain in the same location.
WAIVER SECTION
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. (If you wish to waive the setback, you must initial the appropriate blank below.)
os I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
itPtityptirtrOwner Information) ' cent Property Owner Information)
hi(fit Gt O 5K1 N M;.[du 1 S. Teac
�AE5384D21B0C4F5_ c QCQQ dn F7FrLAAdIF
Signature niNdtr§* Tate
Michel z Goubran Jr
Print or Type Name 12132t3038-ype ad
1170 Iyeye St
Mailing Address IVEVrAddkegg4 3 5
Rock Hill, SC 29730
City/State/Zip qtaitiftgif / tatefarmsi nc@gmai l
704-201-4966
TJl�rp6lumber/email address Telephone Number/email address
10/13020
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

DocuSign Envelope ID 39FA75B3-BA17-42DA-A541-4C19B5AA2861
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Michel Z Goubran Jr 's
(Name of Property Owner)
property located at 113 Swordfish Dr,
(Address, Lot, Block, Road, etc.)
on Inland Canal , in Holden Beach , N.C.
(Waterbody) (City/Town 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
(Indivia al proposing development must till in description below or attach a site drawing)
We propose to rebuild the existing dock, not to exceed 400sqft approx 12x16
and add a roof .
The existing dock will remain in the same location.
WAIVER SECTION
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
m . yo ii to waive the setback, you must initial the appropriate blank below.)
h to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
lybpwner Information) (Adb���g�na�roperty Owner Information)
hiCA-f( 0�I.0N [-kk. V-(-trAz --
AE538402180C41-5OA8 2094014C9ignature igiarure
Michel z Goubran Jr e Kosterman
Print or Type Name P4r1(j4g4egjVame
1170 lyeye St
Mailing Address mwkagn, t .corn
Rock Hill, SC 29730
City/State/Zip CitVatVPgiii/fish drive Holden beach NC-12 28462
7n4-7014gAs
Telephone Number/email address Tel/ 2eNmber/email address
10/12/2020
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

I .•.
tt ft NM 0
NIMPIP , .21 4 .*. .... .1.....
IP
' 4*". IR. .„ ....:iir iir SW irs47041.100.4 ,
•
4.
... , . ,.,,
• ,..,„ i .. pill
4.
fig...-
•
.. I
illi 111-04, . . . . apt
r N?. 66363 A 8 C C:-.) . ik 0 I 111 oll
beaus �PareWRasmusa Rasmus ore promos porn.!mod
_
AAA d Erwi and NruN Resource" .. -`.-itit ``:'�'1c+" e, n� - ,.
rreoronennol concert puma.to I SA IICAC_Sej_32
17 Y‘ .V. P Location. b LNiZ< .acn�F .3 hp,..r :;- ,---... ---. , ,, "1T�" 0,ar ..a•:
ax
i - - ....Aatrud Sate hood lot a(el_-- 'Y' ss•- •-� -- ,r' ,•pro • 't`N
ziP 11130 _L3Sy.r°411At..- ' �d..v..-g 4' ,c. ,, ,,_ . .?r.s+•T' x 4!' „
�NU1 Jydj.YNr.bedl�- - --/ ,r-
Oorar Mal.WV eod1.
I
=r
f
' ...ft.....:".1 i ce16' . ' '\!!Zt
.X�x 3�.4 ' n • ,T R a
-fl�42.(' `''�rl�'��^ A `fir.7 ° �,.
1 I `t .>&t om. ^a ' • "t 'o •• •f't
5 . _ W a . ;µme
. it
- ; ..
L.- -01-11 rol I • - � !• ',,,: .. fi y k,.. Y.
y
t
7'6
h 1 F= as l _.
£nk d.!,vr q�la.
,rt
7 _ j _
i

/ ,e_CALt-D II.R 2,020 / -yku
CAMA/ ❑DREDGE & FILL N° 77611 A B C
C.--)---..)
GENERAL PERMIT Previous permit# ;
❑New ❑Modification El Complete Reissue Partial Reissue Date previous permit issued '//(p/Z .11
As authorized by the State of North Carolina, Department of Environmental Quality -.(L 'G
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC /IoL) .
_ ❑Rules attached.
Applicant Name M I Ch A el Gou 4VA1" r Project Location: County ' r !-�;_ t-... i`1 t
Address 1110 1 Ney� (Jr, Street Address/State Road/Lot#(s)
City RoC,I� bill / State SC ZIP °It) 3U \‘ 5 `�i.-e/iJ(-IS1.\ Or .
Phone# (70'1) 1.0 I -"141(Q(p E-Mail ►i Wt>c.c rcAl v‘okottv,c o►."Subdivision
Authorized Agent . City \ e Ge c ZIP 9-v-1(.0 2
Affected ElCW gEW 1'TA LIES ❑PTS Phone# ( --y------' River Basin L t - Lei'
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA ❑WA Adj.Wtr. Body LA-NA (- (nat )unkn)
❑ PWS:
Closest Maj.Wtr. Body A5 U-'L..)
ORW: yes / no PNA yes / no /
Type of Project/Activity 'RP{ACC c e d d P c Ai/VI a di cc r c o-2
(Scale: 1‘I =Zo )
Pier(dock)length
I. I I I ! I j
Fixed Platform(s) 1 ZX ((a ' I I I
Floating Platform(s) I
Finger pier(s) rt
Groin length I , ,
number - i._.._._L.._..__......_._ _._ .
Bulkhead/Riprap length / '-1 -
avg distance off re ? 1 '
max distaneeoffshore , i ' I {
Basin,channel I I ( i
cubic yards 1 I
Boat ramp I j �iIXt t`r� .r 1" I
Boatho Boatlift ,+
- . -- ar� A t;fit- --- ----
Beach Bulldozing I I I i F
Other I 1 I 1 1
I i
Shoreline Length 'J S
SAV: not sure yes ( ! i I i
I
Moratorium: h/a yes no
_. -.-_ - ---- - -
Photos: yes 67
Waiver Attached: . no �Qy14py E 2\ - I L - 1
A building permit may be r�quired by: 'TOwv O c" I}Ol Jt)r\ gCACI'^' . ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) /� 1
Notes/Special Conditions /1 I r r<I e S 0 7H , ci-ou l Uc i I1 c id-e 0.4461t-el1�J'A( reia(Ahoy r q/)v1
/ r' Y
I . A-4 et. rid" �c,4" Biln�
Agent or Applicant Printed Name Perm icer's P' Name
9 Sce A4-1--tidA,
Signature **Please read compliance statement on back of permit** Si ature
$. ?bo, COD Ipst11 Ib/i3/2o20 4 3 a°20
Application Fee(s) Check# Issuing Datb Expiration ate