77525D - Olson

eCAMA/
- DREDGE & FILL No 77525 ABCD
GENERAL PERMIT Previous permit#
y� New C Modification . .Complete Reissue ❑Partial Reissue Date previous permit issued
v
As authorized by the State of North Carolina, Department of Environmental Quality 0711 /1 O 6
and the Coastal Resources Commission in an area of environmental concern pursuant to ISA NCAC
/9-4
Rules attached.
Applicant Name r f i G ✓a ( C0✓\ Project Location: County / E '/9t'A---
Address L O Z Q P�/-(6 s 10✓ C a-C.42 Street Address/State Road/Lot#(s ,
City IA)/l//N State ZIP Z/l 70 5��3/U s E/ /l ley
2
Phone#(7 S 2) "l t(Z-3- -'3 E-Mail _ _ Subdivision G// )
Authorized Agent -�,4 4n kVCity_ LI/(- ZIP i �1¢1
Affected
❑CW //' PTA ❑ES ❑TITS Phone # ( ) River Basin , O '
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body I W nana�nan /unkn)
❑PWS:
ORW: 40111) o PNA y no Closest Maj.Wtr. Body M'Dvi / ._ S 71id/Coavn
Type of Project/Activity i>1A -54a(( ff.•-6( , 4A. {4)0 I.tti 0C4
%Cf a- /-(-f• (Scale: /?.�i.) )
Pier(dock)length 1 -z t I `1-1--€ •V '
Fixed Platform(s) , y` �1 r- i 414 j11
Floating Platform(s) to .\ ,Finger pier(s) i
.............
Groin gthJ_____r_ 41 � I \`
ti
Bulkhead/Ripra ngth + •44 i
avg distance o re 4 it I 1
- I I
max distance offsho ,t, j
Basin,channel V I 1
X
`
cubic yards
I I j
Boat ramp
f
Boathous Boatlift 11l� —_..... ,. -W7I WI 1 1.k.i.: ' I : \
Beach Bulldozi -_ 1
Other \ 1
I ^ I I
I j —4
Shoreline Length "i/110 ( l5 j�i 1 ' -
not sureyes � W ' I ‘�«
SAV: i —
Moratorium: n/a yes
Photos: yes ocaio } - —
Waiver Attached: yes n , I
A building permit may be required by: . Cl See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) t = / � �p n _ p ��
Notes/Special Conditions \- \ l--�" ' ` O 1 ( �Fes) -�`T�� - + M N t
( T- f . L, NOI— E- i KIT> y4rki.E -- 1-1 MO
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AdA
Agen rApplicant Printed Name P icer's Printed Name
igna re "Please read compliance statement on back of permit** Sign re
' 1()_---- i 261E 1 ,Z .2 5' ZI '2-l
Application Fee(s) Check# Issuing Date Expiration Date

r
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 I)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 Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-648I) or the
Wilmington Regional Office(910-796-72 15)for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-648 I
Fax: [phone] Fax: [phone]
(Serves:Carteret, Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare,Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

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Ng 775.25
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..: ENE- ..RAL" - — PERMIT
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->"--------->- -iiNdw _EIMeidificAtitrn CICorntilete•Reitstie OPartial Reissue Date iSteNilatspOitnitistne
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As a ' '-r gcri))019 State oltiott6-cii:000,:Niicl.rt703iit Of Environmental Quality a7 l , ,, ,./ -:0„r2 ..
andthe Coastal Resent-cm'Commission in anarea of anyironMentalki,orMerOpArspant tOISANCAC. .. ...,. . --.. . .. ,„_.:Rw.-.-6s. , ...,;:. „„.. .. - .._ . .....,
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'Projectiocatton:i County : • -
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A.building permit maybe.reqoired lir. • El See4note'on,back:regarding Riyereasln.ryles:
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AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: �� � ) Sa Ca /41 0 )S Of)
Mailing Address: o0a.77 /U44 ,S - P ,
i4,r /i/ /i 4/ / M L-Ds
Phone Number: 3'2-- E 3 3 C.
Email Address: b1 Sdo or, !7 mar'1 . 641-.
I certify that I have authorized 4 c4e-v (no 06A C sI CDA1" di Ax7
7 Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: tr 44
at my property located at 233 D Sc-Di5IS Hill( Loop
in County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property, rner I n:
Javal- )71-
Signature
Garet-WIJ o Sa ra hA.0 /s o'7
Print or Type Name
<iYllll'I� -�
Title
RECEIVED
1 /51 / /
Date JAN 2 0 2021
DCM WILMINGTON, NC
2-1
This certification is valid through / ' I
5 Co y W _Lc c CAOd�r.

•
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner,C.; .-`ii' ,_ . 56i'f'a/1 tit. 0 I S'.n
Address of Property; , • : ' -' .
(Lot or Street#,Street or Road,City b County)
Agents Name#; `t•rs j r.•_�, � Mailing Address: i
Agent's phone#; fi pt.,.. '7 V . �. t
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 roposing_A description or drawing,with dimensions,must be provided with this letter.
I 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 abjection if you have been notified by_Certified!Vail.
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.
11.I, : ;. ) (Ad -CC Pr rtyt r Information)RECEIVED
0 r rAit I a it,4.7).0,to AG - 'I4, 1 111 )
e JAN 20 I21
- or am{ SQrah lf1• DIS0 Print rtTypeName DOM WILMINGTON, NC
- or type Name
Cr-, SV. 04 C\Vfc,j1C)'� I.'n
e ate~• - 1 -i w •!f
i'``` Matting Address [ t n
Wiling aiD
°' .�- - • \Paf S\C- 1�C\e- I FL 3q `[
_. . c City/State/rip -
-11j)--9)04
Sq 6
G' e"� '' Telephone NumberTelephone Number

Y
- CERTIFIED MAIL•RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORD
Name of Property Owner. "-;1 y o �a 1'Q/1 fil, 5t0 1 �,
Address.of Property: g--1 30 Sc ;i f f oa 0 -I 6
(Lot or Street#,Street or Road,City&County)
Agent's Name•#:-'e$ r, -S'fret Mailing Address: C 2 --h tiO S / .- '.
Agent's phone# P�� ' till 'ct/3e,A. 'A° C' 241.4.4.16
1
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.
. v Zr
I 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 1
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(9i0)790-7215 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 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.) RECEIVED
I do wish to waive the 15' setback requirement. JAN 2 a 2021 . -
• I do not wish to waive the 15'setback requirement.
ncvi WILMI6 OTON, NC
saeely Own r Information) (Adjacent Property Owner Information)
'", . 0/A1, ')-.,,, ,-------_, /€ 4 . jo°'t- - "'fir . 1c9_
--,signatEW`; ' e • tgrfes_ljuo.c. 131_,AsibEL,
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Prin or Type Name ©P t or Type Name J v r
j i Z ( , 2 t\r toy.
: . yet ('k c t� . . - i1 5 4L -a'uiP ,1 1,
�" �`i • Mailing AddressMailing Address AlAJ/
city/s ate 15- i - City/State/Zip
9.3 3,41-' S3 9/0- 7f, -7��,�
Telephone Number Telephone Number

Check
Date Received Date Deposited Check From(Name) Name of Permit Holder V.odor 71/ amount Permit NumbenCommanta Receipt or Refund/Radlocated
Columnf Column2 Cofumn7 ColunoN Columnl Column6 Cotunn7 Column8 Column9
_1/26/2021 Davey Resource Group Inc T Beach Bay Lane,LLC United Bank 2170 S 200.00•GP#77757D KE ret.13662 , _
1126/2021 Clements Marine Construction Patterson FCB 5627 5 400.00 GP#77748D KE rct.13663
_
126l2021 Allied Marine Contractors LLC Todd and Ronica Fortanini FCB 9756 5 200.00 IGP 977528D - JD rct.13610 _
1/26/2021 Southeastern Coastal Construction Co. Gary&Sara Olson South State Bank T- 12068 $ 200.00 IGP#77525D JD rd.13609