33509D - Olsen

0 CAMA / DREDGE & FILL N9 33509�
GENERAL PERMIT Previous permit #
)C New Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
f-9r\r //
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC ri i j JN -) t7 600.
/�— Rules attached.
Applicant Name _G�ed v/SG n C -� Project Location: County i .
Address a (' Ci cA'711 !v 6- Li/ Street Address/State Road/Lot#(s)
City L n/ N t o A 1- t/V State M ZIP ,2-U .57' _ ?O 3 Z
Phone#(9/0_ C;185 ?WQfr( ) Subdivision
Authorized Agent 57 JE .A"7/Nv/7 / City 5t &) 'rcf' ZIP 2-6y y c-
—
Affected LCW jEW , PTA , -S ❑PTS Phone # ( ) River Basin 0/9/, f1]/L
❑OEA ElHHF ElIH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body n A-rti f}L (nat / 0 nkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes /�' Crit. Nab. yes / no Closest Maj.Wtr. Body ]� j�7I .Sou N�j
Type of Project/Activity twidioc. Fo/c1N6, l3ULKNPA}DD, 017- /N nIPW i1/g'L t 0_6cag't i7 Oeue
fk i 2 Ftr-' j/J/ b` .6 di4 T L/F 7 (Scale: I �.�/U )
Pier(dock)length t/p X (0,
A ,�+
Platform(s) i 9 x/yl 6l/Qi'l¢'t7J ' I ! ' f —_� —
1 �. i i,
Finger pier(s) z x Z 0 j I
+ ro
t I —+ r
� �—
Groin length j
number f 1 t i 2-)C ZCD
Bulkhead/Riprap length I
avg distance offshore 11111
-. _—_... .— --.
max distance offshore I — I —
Basin,channel ' -- - >4 !2 ,
1 , )0_)1 H
cubic yards I _
r — L1 !
Boat ramp 1�x 3ro 1_
Boathouse/Boatlift j I I
Beach Bulldozing . - , i v .: .PM.
Other .,4 L , X(o . _I. , 1
F.X/ '
17_, T
VA ._ r t
SAV: not sure yes no -.-. %- ') ,/ I / . / r I i 1 l
Sandbags: not sure yes no I ,
Moratorium: n/a yes no I 1 t
y '/ ,Y _ __ _ t__
I
Photos: es no fiL (itJd�� - W ik _-
Waiver Attached: yes no
A building permit may be required by: 4j/f' t�i /7 . H See note on back regarding River Basin rules.
Notes/Special Conditions POT 7 sX7h. Aivty ru/2 zz TPA") 1,/ df 7
i V Ili OF 7- Lc-ATEA- toot/y
� QhEr`l (: i4A-1i1�10( \
Agent or Applicant Printed Name Permit Officer's Signature
--, _ <. ; ,�-,_7 i1- - .y o_5 S_it — O3
nature **Please read compliance statement on back of permit** Issuing Date Expiration Date
Application Fee(s) Check# 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 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 Quality. Contact the Division of Water Quality at the Washington Regional Office(252-946-6481)or the Wilmington
Regional Office(9 I 0-395-3900)for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District Washington District
Mailing Address: 1367 U.S. 17 South 943 Washington Square Mall
I638 Mail Service Center Elizabeth City, NC 27909 Washington, NC 27889
Raleigh, NC 27699-1638 252-264-3901 252-946-6481
Location: Fax: [phone] Fax: [phone]
(Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Bertie, Hertford,Hyde,
Parker Lincoln Building
Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
2728 Capital Blvd. Counties)
Raleigh, NC 27604
919 733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: [phone] 15 I-B Hwy. 24 127 Cardinal Drive Ext.
Hestron Plaza II Wilmington, NC 28405-3845
Morehead City, NC 28557 910-395-3900
202-808-2808 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Carteret,Craven,Onslow-above Onslow-below New River Inlet-and
New River Inlet-and Pamlico Counties) Pender Counties)
Revised 10/05/01
www.nccoastalmanagement.net

l�T RAL PERMIT COMPUTER FORT
APPLICANT NAME: (ago rQt2, OLSE rs)
ADDmON_fiL NAMES: J?etrk. 14 NT(NO at
AEC DESIG: ( i P /, DE=V'LOP 4R�4: PROJ DES C: P - j Z
(Wig only take 6) / ---- :.'.
(R•tZl onlytai;e 1) •
WORK: (z, a' G to Sy q 3
(Will only take 4)
5p )21 30 EL- - 10J icj
. NL4LNT:
(W 3 only take 4)
1.(.1 5 j( 5A .qc -
(will only take 6)
.,
ACTION 'P14TION
DREDGE&FIT1 REQUIIZEn: ate(/ a3
S-N o3
CAM&MAJOR DEV REQIJIR as"L(-p 5 S H-0

-ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2, and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. 0 Agent
■ Print your name and address on the reverse X �•.- _ Ci r 0 Addresse
so that we can return the card to you. B. Received by(Printe. ame) C. lye of[liver
■ Attach this card to the back of the mailpiece,
or on the front if space permits. ► C - C I f •`.
D. Is delivery address different from item 1? ❑ Yes
I. Article Addressed to: If YES,enter delivery address below: ❑ No
SC �- 3 4eS
1. 030" 1'
�l/r / I L ' �Serv' Type
Y
3. id Certified Mail �❑ Express Mail
LIL/ L ❑ Registered Ild'F?eturn Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
?. Article Number
(Transfer from service label) 7002 0 510 0001 1866 2236
'S Form 3811,August 2001 Domestic Return Receipt 102595-02-M-15

UNITED STATES POSTAL i L First-Glass Mail
SEPT��' k-F FQstage&.Fees'Paia
'L tTPS_ ..
M C' ermij to.G=t9
ry w_
• I!, JANd
• Sender: Please prinQQur,farne, address, and ZIP+4 in this box •
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;44 .+ :3 iiiiiii„iiii,fLi„i,i.1,1“.1.11.11.11„ii.i,►,iimiiui

ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items-1,2,and 3.Also complete A. Sig!ture
item 4 if Restricted Delivery is desired. �— /, 0 Agent
• Print your name and address on the reverse X AA -114✓ ■ Addresses
so that we can return the card to you.
• Attach this card to the back of the mailpiece, B. Received by(Printed Name) gate of Deliver
ktO
or on the front if space permits. I
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: If YES,enter delivery address below: ❑ No
a9bb I
)/ ock PiAky
` ' 4 �1 3. Service Type
U�r 1 N r�l\ B'Ertified Mail ❑ Express Mail
f � ❑ Registered Dicturn Receipt for Merchandisi
2 ❑ Insured Mail ❑ C.O.D.
2 J 4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number 866 2229
IaheI)i.fl. J.f, 0 0 1
'S Form st 2001 Domestic Return Receipt 102595-02-M-15

UNITED STATES POSTAL SERVICE First-Class Mail
111111 Postage&Fees Paid
LISPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
t AO'I No i? ;
CPG? t-{kiti r2-j
a-01ty P\tdcre �c ;

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ADJACENT RIPARIAN •PROPERT .a 2 4r -�v; .f, .'WAIVER FORK .
•
}y
Name Of Individual Applying• For per` t � '�:-:-.47. -5k ki .•1J Le/"
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Address Of Property: 1 __••,._•
o-Zj•Z _ $ .,,
• r .`1 ! r . T
(Lot or. Str •et , , ,dad:; City & County.)
' '..•-. -i-'.',.:::1.:::.grb:i.:QII:nigin,7,_•.V.::‘:',... - .I hereby certify ' that I..- own prop t4�' r
, F •"'-, ,, t :to the•. ,above-
referenced -property. . The: 3.nd3:V;iduaI �A, a = this permit has
described :to • hie •as_ shown or the �' ta" _ w ?.- g the oeve.lopment,
they, .are- proposing. ' A descript t r• r v with di mensions
should be provided with this "letter ''". ,
r ,f
. .Ass��I have no ob1.ection 'tp t ij. 0 000- a* •
•
y .( r'4,C ti
If v.ou have objections" to what F f�
Division of Coastal Manaaeme - . b a � base write' the
Wilmington ; North Carolina s ' qk =, g4 tt: } ' i2ns. o1
days of r.eceiDt of-this' ot- -de } F
. •a-S no-'-objection if ou hav=. b Rr' s- 114r'-s xceere3 t ;e `same
nK f eo Ma'_i'1
-.., bd,'o .r, yi -
a.
- I understand that " a ler � -`:{y`� ° `
P , dock, moor
house, lift or sandbags must be ,se° breakwater,: boat
from my area of riparian access tan1eSS edls.(Ifce of . "I '
to waive the setback � �� ( Yo'u wish
below. ) , You mus: ih 7l z a i -:opriat:e blank.
k v
1-1*-;lrie ___1_,..6.1.2-L_
• . . .
I do wish to:`••-wain 7 r y` �`'&. •
ttx �.. egLirement.:
I 'do not wish to waive th's
ti, r:equrement.
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ature T c
int. ame ;E x4
Telppho ,_ /'=5 ,-, t k
umbe ,-• With Area Code �'
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BANK OF AMERICA
ANTINORI CONSTRUCTION 3 5 9 5
896 HWY. 210
HOLLY RIDGE, NC 28445 66-19/530 2 _v V-.0 3(910) 327-3475 7 2
0
0
It
POT HE /i/ /3 s-/V7e $ 5-0 - a
ORDER OF
?;0 --
DOLLARS r
•
. 4. C ...,„_____.
MEMO CR^ ' 545Q AUTHORIZED SIGNATURE W
u■nn 1 c q co 1:o 5 3000 1961: 000 6 50 5 2 191100