72680_Matthew Ryan Oliver_20190416

fil 'CAMA t f u -DREDGE & FILL No. '72.61801 ... .. ..... . 8 C D
GENERAL PERMIT Previous permit #
hNew I lModification LIComplete 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 15A NCAC /V
$4 Rules attached.
Applicant Name 'k + ycl "1 0 Project Location: County
......... .... ....... .. .
n
Address Street Address/ State Rea d/ Lot #(s)
61 C] State zip 7
Phone# . . ..... ud c ',Ij"
E-Mail J, _S b ivision,J-1/1
-- ---------
City-
Authorized Agent _-A) .. . . .....
... . ..... .... ............ ....... ...... .. .
Affected L] Cw E W 1h] PTA I p',J E S �71 PTS Phone # River Basin
AEC(s): 1, J OEA LHHF [11H El UBA [�."] N/A Adj. Wtr. Bocly_'� kn)
F] PWS:
Closest Maj. Wtr. Body
ORW yes / (jno"PNA ',� yes / �no')
Type Project/Activity
j. .... . ....... . . .... .....
Pier (dock) le
Fixed Platforn
Floating Matfc
Finger pier(s)_
Groin length
11" ­,",. n9mber
(Bulkhe " d'' Rip
"."Avg dicta
max list
Basin, channel
cubic yai
Boat ramp
Boathouse/ B(
Beach Bulldoz
Other
Shoreline Len;
SAV: W
Moratorium:
Photos:
Waiver Attach
A building permit may be required by: A L'k
( Note Local! Planningjuris&ction)
Notes/ Special Conditions J1
S
Agent or Applicant P6nted Name
(Scale -
See note on back regarding, River Basin rules.
PermitOfficer's Printed Name
ei
. ..... .. . .
Signature Please e read compliance statement on back of permit rniit** Signa ure
. .. ..... .... .. -
Application Fee(s) Check # Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: &42Z _
Mailing Address:
JA
Phone Number: 50- 4L -
Email Address: 6_1 j M
0
I certify that I have authorized &,Oliver lJa�OA
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development:
at my property located at � 3 p9k�
in bov e. County.
/ furthermore certify that / 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 Owner Information:
d) � /i I Z i4-1/ram
tgnature
MVev'/-
Print or Type Name
Title
' / /& I' 1-
Date
This certification is valid through
Revised Mar. 2016

Lei
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:'Aa--)-�-
Address of Property:
Agent's Name #:
Agent's, phone #:
2 ) 3 " 7,) , 6 / (" 2,
(Lot or Street #, Street or Road, City & County)
Mailing Address:
� 0 ,,, a d
-015 5r-
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 drawingjhe development
they are proposing. A description or drawin_q, 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. Contact information for DCM offices is
available atptil 2, ,�Lw�ww. ticcoastalinang!geLyietit.netlweblcinl,,; tatt liir or by calling 1-888-4RCOAST
No re22onse 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, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 16from 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.
11 do not wish to waive the 15' setback requirement.
(Property Owner I rmation)
Signalure
Print or Type Name
0 ) 5 5 81 Ue,
Mailing Address
16JAell'-11
cityls atelzio
1 6-
Telephone Number /Email Address
Daw
(Riparian Property Owner Information)
Si > ialure
4�
Print or Type Name
Mailing Address
GitylStatelZlp ft
a Q
Telephone Number /Email Address
Date /
(Devised Aug. 2014)

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
e a
Address of Property:
(Lot or Street #, Street or Road, City & County)
Agent's Name #:,___ . . ...... . .. Mailing Address:
Agent's phone #: . . ..... . .
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 drawingthe development
they are, proposing. 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. Contact information for DCM offices is
availableatptte.Llvy .Liccoast,iiii)anci inetit.i7etlweblcrnlstiff-lisi'I orbyeallingl-888-4RCOAST.
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, boat ramp, breakwater, boathouse, or lift 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.
(01roperty Owner lAformation)
S.,
Print or Type Name
Mailing Address
Ve K
cityls telzip
" I
Vn
(7�2—ul - /I / - 754
Telephone Number /Email Address
Date
Property,,PwnoInformation)
Sign, 11) e I
Lea vq
Print or Type Name
Mailing Address
citylstatelzIP1
3 `3
Telephone Number / Email Address
(Revised Aug. 2014)

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NC Division of Coastal M9t3 Habitat ImPact COMPut8r ShOet
Applicant: Permit
Date: V
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
iqjEact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
Dredge [:1 Fillb, Both El Other El
c<&
Dredge [I Fill ffig"oth [I Other El
/L'
Z
Dredge[] Fill C] Both El Other R-
G b v
f Z— (i
Dredge El Fill [I Both Ej Other El
Dredge El Fill D Both El Other El
Dredge E] Fill C] Both [I Other C3
......
Dredge El Fill(:] Both [I Other n
Dredge (:] Fill Ej Both rl Other El
Dredge E] Fill Ej Both [3 Other El
Dredge[j Fill[:] Both 171 Other El
Dredge (I Fill [:] Both M Other n
Dredge 111 Fill Ej Both El Other D
Dredge El Fill El Both El Other 171
Dredge ❑ Fill 171 Both EJ Other 0
Dredge ❑ Fill [I Both F-1 Other 17-1