89999A - Oliver, Rodney

vs CAMA 4DREDGE & FILL N° 89999 �s c D
—
GENERAL PERMIT Previous permit
Date previous permit issued
few ❑Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by thejSt%y to of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
ISA NCAC t rr ��ao - Rules attached, General Permit Rules available at the following link:^^•^•�d��anv/CP.MArules
Applicant Name Uf G( Authorized Agent �Z„ U Tly' y rl "Rs't I� t• ah a 7 -
Address //�� 7 b�. SI 0- U Z .S r 6. r �iLA o IF Project Location (County): p
City AAAo.&AaA state VA- ZIP 2eo3 Street Address/State Road/Lt#(s) - Wct.5 r'otiOoTOot3A-_. L4
Phone # (?Oj)?. aS 2.$9 O + 2
Email C AVA V t r 1,5 ie 0.. l J, G o Subdivision '� �� �o � n y S -C 3
City Allmi A ZIP 9 % g /
Affected 0CW JKEW g4ffik Un S— OPTS Ad). Wm Body C' n (nat/ a unk)
AEC(s): FOEA [JIHA 0UW [-]SPIMA �PWS Closest Mal. Wtr. Body P0./K/-'ea >�^�
ORW: yes/(Ef)� PNA: yes/4t)
Type of Project/Activity t�0.Cam- 2X.15*Ji4
Shoreline Length fi g O r r
Access Length IX e ,
--------
Pier (dock) length
Fixed Platform(s) -
Floating Platform(s)
Finger piers)
Total Platform area
Gr hlq_--.r--
Bulkhead Iprap length * s
Avg distance offshore
Breakwater/Sill '� r
Max distance/length 7.
Basin, channel
Cublcyards �
Boat amp
Boathouse/ Boatlift
Beach Bulldozing _ �n
Other 3
SAV observed: yes no
Moratorium: n/a yes
Site Photos:
Riparian Waiver Attached:
A building permit/zoning permit may beerrequired by:
Permit Conditions
Aw�t t 2� Owl/Ktti..a,d.
1
EX, �UL1<ke7WO T L.jk , ti
D./VET -
AND
TAR/PAM/NEUSE/BUFFER (circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
Agent ot� licant PRINT me Permit Officer's PRINTED Name
shnat - Please read compliance statement on back of permit" Signa e
o� /0s-D i/a's Av
Application Feels) Check k/Money Order Issuing Date Expiration Date

❑CAMA F DREDGE & FILL N9 89999 A B C D
GENERAL PERMIT Previous 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. 0 General Permit Rules available at the following link: www.deq nc gov/CAMArules
Applicant Name
Authorized Agent r -
Address
U Project Location (County): i
City
State
ZIP Street Address/State Road/Lot #(s)
Phone # ( )
Email
Subdivision
City ZIP
Affected ❑ CW
❑ EW ❑ PTA
❑ ES ❑ PITS Adj. Wtr. Body (naUmanjunk)
AEC(s): ❑ OEA
❑ IHA ❑ UW
❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no
PNA: yes/no -
Type of Project/ Activity
2�
(Scale: & )
r_.
Access Length
Pier (dock) length
Fixed Platforms)
Floating Platform(s)
_
Finger piers)
1
I
_
i
Total Platform area
Groin length/k
length
Bulkheadnce
offp
Avg distance offshore(--
Breakwater/Sill
.a_
Max distance/length '-
TBasin,
channel
TL-7—f-
j--
-
Cubicyards
Boat ramp
-
Boathouse/ Boatlif[7
Beach Bulldozing_
7-
I
Other
SAV observed: Yes no
Moratorium: n/a yes no
Site Photos: es no
v
Riparian Waiver Attached: yes no
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A building permit/zoning permit may be required by:
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
f
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
i
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit -it Signature
Application Feels) Check fJ/Money Order Issuing Date
Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: ova *t4
Mailing Address:
q0 �-5 �Cocwv"
244-/A[m-/V
Phone Number: 1)0--� —Zr23 2 b
Email Address:
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining al11lCAMA permits
necessary for the following proposed development: �U) I�WW
at my property located at 5CI06"5
oprtu
in 11-�/ , 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 Owner Information:
Sign tore
Print or Type Name
/VI U
Title
72- pzN
Date
This certification is valid through __L —11f �74

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_ _ _. i

See Camuniy lob
R m"IR Summery
Parcelx:0137WIX)
PINMIHPIO0K]5
Tax GlatNct•.Avon
Suix ivhbn: Hatlarm Colony Sac 3
Lot BLKS : Lot :83 Blk: Sec: 3
Praparty Use: Reaiaenaal
BuildIN Type: fieach Box
Year Bu l It: 1977
E mallet OwnenNo
Tex Oanemi Oliva. Room, W -Primary B .Ver
Olver. Val L -Pmnary Ovmcr
Wiling AOOrns: 4025 Trans M-q
AnnaMala, VA22003
Tax Year Values
Bullainm Velue:3105900
Load Va81a: SIIB.300
K.1 S10M0
Total Value: SM 400
Sl/zK/G Z_�`t

N.C. DMSION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWANER FORM
Q; RTII IE MAIL RETURN RECEIPT REO&.$TEnor HANQ.�EzLXE}2Y
(Top portion to be completed by owner or their agent)
Nome of Property Owner. i On u e y W aty-(R
„ ... , • ., �'r[�1i7�1�i.+2%7�1a1J�i►l►,r].�.�l��y'li►
Agents Name: (.27A4ti_ Or��r6
Agents Email:
Agent Ph*rH* '2 51 '305 i
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(99M PRIO to be completed by the AdiaAM Pmwrty 0"to
1 hereby artily that I own property adjacent to the above referenced property. The individual applying for this
07'1
t r dray d to with
as nslo on the attached drawing, the dcvelopmeM they are proposing. A
or drawirra. with dimensions. must be orovMed with this latter.
DO NOT have objections to this proposal, I DO have objections to this proposal.
rt you nave otyectrons to wear is oeing pruposK you must noM the N.C. Division of Coastal
Management (DCMJ In writing within 10 days o1 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 (262) 264-"M. No response Is considered the same as no objection if you have been
notified by Ceri ied Mail.
ULUT14J14X61IIOU
I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lik or
groin must be set back a minimum dlstance of 15' from my area of riparian access unless waN+ed by me
(this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must elan
the appropriate blank below.)
I DO wish to waive somelall of the 15' setback
Signature of Adjacent Riparian Property Owner
/-OR-
'0/I do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacent Riparian Property
TYPedhPrinted name of ARPO:
Mating Address of ARPO:
ARPO'ssmall: „a en. ary ARPO'sPhone#: 5-541-3(11 -XV13
Daq:-A
q-waiver is valid for up to one year from ARPO's Signature'
Revised July 2021

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVERFORM
.,, or_rt IRN RECEIPT REQUEVf. or unk,� __.
(Top portion to be completed by owner or their agent)
1? Y W i V ��
Name of Property Owner. �, —j— _ r r A
Address of Property: � `- ' " -
es
Mailing Address of Owner:
I©2 -d4�RKwyAyO_iA�1��zoa3
n �tP t�'iCiOv� C4�wner's Phone#: _ iO3 2.(7 , Z
Owner's email: �� t
Agent's Name: t.Q "tn✓ ��1 �$a Agent Phone#: z 52 3o5 &A?
Agent's Email:
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom m 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 forthis
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.
(Q---1 DO NOT have objections to this proposal. I DO have objections to this proposal.
if you have objections to what is being proposes, you muse nonry ree rv.�. unv,a,vu V, ��u—,
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. DC,i1 representatives can also be
contacted at [phone]. No response is considered the sap; a as no objection if you have been
notified by Certified Map.
WAIVER SECTION
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
-OR-
-,/do not wish to waive the 15' setback requirement (initial the blank)
Signature of Adjacenta Owner:
Riparian Property
Typed/printed name of ARPO:�
Mailing Address of ARPO: -7 33
q2:� nooV
ARpo,s email•�ARPO's Phone#: ��
Date; (�� G as 2 waiver Is valid for up to ono year from ARPO's Signature'
Revised July 2021

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