87157A - Tolleson, Edwin and Patricia

•�A"" IR�CAMA ® DREDGE & FILL
NQ 87157 C&
Previous
GENERAL PERMIT
permit
Ji
Date previous permit issued
M New ❑ Modification []Complete Reissue
❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC IA - I f 00 d' j'M ❑ Rules attached.
❑ General Permit Rules available at the folkrwing link: www.den.nc +ov/CAMArules
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Applicant Name EL-3^ t WAYyCiC, olileSon
9 Address 00l�j
�ctle L.ca5V2
Authorized Agent
Project Location (County):
gg��ck
City \Y'� l t11 fA rJ24.[�lState VA ZIP 2 3�Sfo
Street Address/State Road/Lot #(s) _ WC 3m
'11 7 ©- 3`12i'2_.--
Phone # (
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Email �'hou25t)Yt @Cox. he�
T
Subdivhioo" V6 icko.ax 1Lj anU
clry �4er wr�l zIP 27 fqq
Affected ❑ CW ® EW ® PTA © Es ® PTS
Adj. Wtr. Body C42 tlLid (nab/unk)
AEC(s): ❑ OEA ❑IHA ❑ UW ❑ SPIMA ❑ PWS
Closest Maj. Wtr. Body f'f D�L� •sO�A�d ____
ORW: yes/O PRA: yes/CD
e,.
Type of Project/Activity ShS�t:.L� & oQ Neao
r!
&M-1ceJ tj �ons�"1tnGt G ��rK7t
she,�;cSs cl�=ct�
(Scale:r'�'td ?
Shoreline Length rZ- I CUJ
_
Access Length
Y
Pier (dock) length l
Fixed Platform(s) _
Floating Platform(s)
Finger pier(s)
Total Platform area
f
I
--
Groin length/N
- --1
f '--+--f—i
—r—r-�--'`
ulkhea Riprapap length
Avg distance offshore
- �� -i �-- i ,_- ;
� --`-' -
Breakwater/Sill-
Maxdlstance/length
��
i
Basin, channel
yards
rCubic
Boat ramp
Boathouse/ Boatlift
i - I
Beach Bulldozing
''',-�
Other
r i
i 'i
r
SAV observed: yes J ( r f
Moratorium; yes noc f F
Site Photos: Cye `e no
Riparian Waiver Attached: yes ® ,_. ^f�..
A building permit/zoning permit may be required by: 4!-! n1 JLkVV`QY..S LS�kfV�-lr
✓
Permit Conditions
Edwin Tolleson
Age yAppgc�pjyPNINTED Name
G7i /6L�G'P.Q6/1i
Signature "Please read compliance statement on back of permit--
Application Feels) Check #/Money Order
Permit
PRINTED
❑ TAR/PAM/NEUSE/BUFFER(cirdeone)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
i fzg /30 /zH
Issuing Date Expiration Date

AMA ® DREDGE & FILL
GENERAL PERMIT
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
N9 87157
Previous permit
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC it 0 V 1 Zw
❑ Rules attached.
❑ General Permit Rules available at the following link: www.deq nc gov/CAMArules
C1714
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Applicant Name FtJtWtr\ $ 3&Ayhctc\
'�
1oklesoiN
Authorized Agent
Address 2,004 IZoex L0.Ke j..[
p
Project Location (County):
S
City V yr 0.l n; Ot &ACCIAState VG
ZIP 2 3q IF(*
Street Address/State Road/Lot #(s)
o';'t
(;, 2 k d (o 7J
Phone #(�7) 710-11442
r.
i
Email ei'oue SGyt @C 6X. via
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Subdivision1 «,((tt �{[f414 Zslix6d
City CYCKq'i'i+Y/-tM
�-t t��at��!
ZIP %Z / l 7 7
Affected ❑ CW NEW O PTA
❑ ES © PTS
Adj. Wtr. Body `AkAl
(na nr /unk)
AEC(s): ❑OEA ❑IHA ❑UW
❑SPIMA ❑PWS
t
Closest Mal. Wtr. Body l-H6�rt,�1r if
C' I
sy—tri
ORW: yes/a) PNA: yes/CD
Type of Project/Activity ' hSTc:tli 10' of Ne ,t &••lORJ, d X 9 r
shm'csiAA ctecC (Scale:#„toy
Shoreline Length h/— I U3 t
Access Length
Pier (dock) length I% t XY r
Fixed Platform(s) r _
v 3- ^
Floating Platform(s)
Finger piers) ^
Total Platform area
Groin length/#
ulkhea Riprap length
Avg distance offshore
I f
Breakwater/Sill
Max distance/ length
3
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed:
Moratorium:
yes
yes
no
!/
Site Photos:
<3
no
Riparian Waiver Attached:
yes
(a
.f
P 1
A building permit/zoning permit may be required by:
Uf'?- a`t S CoIL&Mkl
Permit Conditions
CRC
Agent or Applicant PRINTED Name
{V\tti
Permit ce% s PRINTED
01
,ya
� rib 5�,✓�e�
rti
❑ TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
1-1 See additional notes/conditions on back
(Please Initial)
Signature "Please read compliance statement on back of permit" Signature
''too"", 3120 '�oizY ��3oizN
Application Feels) Check #/Money Order Issuing Date Expiration Date

�`°""❑CAMA ❑ DREDGE & FILL N9 87157 (Ar B C D
Previous permit
3 GENERAL PERMIT Date previous permit issued
New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArvles
Applicant Name _
Address
City
Phone # ( )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #
Subdivision
City ZIP
Affected ❑ cW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Won Body (natlynwunk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body !
ORW: yes/no PNA: yes/no -
Type of Project/ Activity
(Scale:!" 10' )
onoreune Lengul
Access Length
-
--
Pier(dock)length !
Fixed Platform(s)-
115�-
Floating Platform(s)
Finger piers)
r
—.
-----
F-1
—
-
-
---
v
k
>
.
v¢.
-
Total Platform area
Groin length/!i
Bulkhead/Riprap length -'
Avg distance offshore
-
.
I -i
�t
T
--
--"{
--
-
------
—
I
Breakwater/Sill
Max distance/length `�'
j
It
!•`•'
Basin, channel_..i_
Cubic yards -
Boat ramp
k
Boathouse/ Boatlift
Beach Bulldozing
-rr.•-_.-_'
''
""'
-
Other
Ii_
_•
j
__`
SAV observed: ., yes
Moratorium: `n/at yes no
Site Photos: yes no—
Y
r-
Rinarian Waiver Attached: ves no
-
%--
-
7
A building permit/zoning permit may be required by: i �' (G' c • T4'•-r' 'n S OlA n l
Permit Conditions
TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
I AM AWARE OF STATUTES CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Signature **Please read compliance statement on back
Application Feels)
Permit Officer's PRINTED Name
rit** Signature
Check if/Money Order Issuing Date Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property:
Edwin & Patricia Tolleson
Lot 63M Flyway Drive Hertford, NC 27944
Mailing Address of Owner: 2004 Rock Lake Loop Virginia Beach, VA 23456
Owner's email:
Agent's Name:
Agent's Email:
[e-mail]
Owner's Phone#: [phone] �gC ` V /c
C
Agent Phone#:
JAN 2 9 2024
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION DCM—EC
(Bottom portion to be completed by the Adjacent Property Owner)
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.
I DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must notify the N.C. Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION (Choose only one)
I understand that any proposed 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
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive somelall of the 15' setback L �
Signature Riparian Property Owner
-O R-
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email:
Cassandra McLean
ARPO's Phone#:� �� / i�
%LJLI
Date: % 2 ` --.2 L( 'waiver is valid for up to one year from ARPO's Signature`
Revised August 2022

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION & WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners (15A
NCAC 7J.0204(b)(5)). Proof of actual notice (a sign -off by the owner on this form) or certified mail return
receipts (showing delivery of notice) are needed.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to) the proposed development,
and to give DCM an opportunity to consider these comments/objections before a permit decision is made.
"Permission" of adjacent property owners is not necessarily required for DCM to issue a permit; however,
permission must be obtained for certain types of proposed developments if they fall within a 15' setback area
along the riparian access area of the adjacent property, as determined solely by DCM. It is in the applicant's
best interest to provide comprehensive and accurate notice so that any concerns or objections can be
resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals the
permit decision, insufficient notice could be a basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent? (Note DCM reads this broadly to ensure comment by potentially impacted neighbors)
A property that shares a boundary line with the site of proposed development; AND
• A property that fronts a natural or manmade waterbody that is connected to coastal waters and
can support some form of navigation, even a kayak or canoe, including a common canal system
or a manmade basin.
• Easement holders? Yes, if the easement could be impacted by the proposed development.
• Streets/Roads? Only if the streettroad could be impacted by the proposed development. This
might include street -ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a
question about whether an adjacent property is considered "riparian," please reach out to DCM Staff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
WholWhat is a Property Owner?
For private individuals (orfamilies), send notice to the address listed on the tax card. If the property is owned
by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of
State's Corporations Look Up site: https://www.sosnc.gov/search/indexleorp. For Condominiums or
neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a
corporation, for which you send notice to its registered agent).
What is Notice, and how do I ensure it is received?
• You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
• You can hand -deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed & returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
Revised August 2022

6\ 1 ��
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RECEIVED
JAN 2 0 2024
DCIVI-EC

RECEIVED
D E C 0 1 2023
DCM-EC

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RECEIVE®
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Nov 2 9 2023
oC; f -EC

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
CERTIFIED MAIL RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner:
Address of Property:
Edwin & Patricia Tolleson
Lot 63M Flyway Drive Hertford, NC 27944
Mailing Address of Owner. 2004 Rock Lake Loop Virginia Beach, VA 23456
Owner's email:
Agent's Name:
Agent's Email:
[e-mail]
Owner's Phone#: [phone] -RECEIVED
CE1VED
Agent Phone#:
JAN 2 9 2024
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION DMEC
EC
(Bottom portion to be completed by the Adiacent Property Owner)
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.
I DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposes, you must nosry we rv.t'. utvisiuu ul a Vaam,
Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be
mailed to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909. DCM representatives can also be
contacted at [phone]. No response is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION (Choose only one)
I understand that any proposed 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
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign
the appropriate blank below.)
I DO wish to waive some/all of the 15' setback
Signature of Adjacent Riparian Property Owner
-O R-
I DO NOT wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property Owner: (_"�`_�
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email:
Cassandra McLean
C,d °tuI 4e tfo - Li w( 97Fyy
T c� f f/
ARPO's Phone#: ( � � 3 F /�-7 J -Jl `�
Date: - — 7; —*waiver is valid for up to one year from ARPO's Signature*
Revised August 2022

TIPS FOR ADJACENT RIPARIAN OWNER NOTIFICATION & WAIVER FORMS
CAMA Regulations require notice of proposed development to the Adjacent Riparian Property Owners (15A
NCAC 7J.0204(b)(5)). Proof of actual notice (a sign -off by the owner on this form) or certified mail return
receipts (showing delivery of notice) are needed.
The purpose of this notice is to make adjacent riparian property owners aware of the proposed development
so that they have an opportunity to provide comments (or potentially object to) the proposed development,
and to give DCM an opportunity to consider these comments/objections before a permit decision is made.
"Permission" of adjacent property owners is not necessarily required for DCM to issue a permit; however,
permission must be obtained forcertain types of proposed developments if they fall within a 15' setback area
along the riparian access area of the adjacent property, as determined solely by DCM. It is in the applicant's
best interest to provide comprehensive and accurate notice so that any concerns or objections can be
resolved early in the permit review process. In addition, if the adjacent riparian property owner appeals the
permit decision, insufficient notice could be a basis for granting such an appeal.
Who is an Adjacent Riparian Property Owner?
What is Adjacent? (Note: DCM reads this broadly to ensure comment by potentially impacted neighbors)
• A property that shares a boundary line with the site of proposed development; AND
A property that fronts a natural or manmade waterbody that is connected to coastal waters and
can support some form of navigation, even a kayak or canoe, including a common canal system
or a manmade basin.
• Easement holders? Yes, if the easement could be impacted by the proposed development.
• Streets/Roads? Only if the streettroad could be impacted by the proposed development. This
might include street -ends which might be used for parking and beach access.
• Holders of recognized submerged lands claims/shellfish franchises.
What is Riparian?
Do the boundaries of the adjacent property legally intersect with the water at mean high tide? If there is a
question about whether an adjacent property is considered "riparian," please reach out to DCM Staff -
especially on the oceanfront beach where there may be undeveloped parcels on the beach or in the water.
Who/What is a Property Owner?
For private individuals (or families), send notice to the address listed on the tax card. If the property is owned
by an Inc. or LLC, please send notice to the person listed as the registered agent on the NC Secretary of
State's Corporations Look Up site: https://www.sosnc.gov/search/indey,/corp. For Condominiums or
neighborhoods with an owners' association (HOA/POA), send notice to the association (which is usually a
corporation, for which you send notice to its registered agent).
What is Notice, and how do I ensure it is received?
• You can meet with your adjacent property owner, provide a description or drawing of the
proposed development, and ask them to sign this form and return it to DCM; OR
• You can hand -deliver this form and a description or drawing, and ask your neighbor to return it to
DCM (consider providing them with a stamped envelope); OR
• You can mail this form by USPS Certified Mail, return receipt requested (the Green Card). If you
choose this option, you must provide either the signed & returned green card OR track the
certified mail package number on USPS.GOV's online tracking system, and provide the tracking
print-out as proof of delivery to DCM
If you have any questions about this process, please reach out to DCM Staff and DCM Legal Counsel
and we will work to answer your questions.
Revised August 2022

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