89236A - Zettervall, James and Brenda

°�°"° " ❑CAMA ❑DREDGE & FILL NI? 89236 A B C D
t 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 ( 'III { 16 (.l ❑ Rules attached.
Applicant Name d r'lr-'t v c; i I (•I wt r i -4 r.1 c- rl r-i
Address . -i, C�-Ji r
City i State hi l' ZIP 4 *7
Phone # (_) - 4 4•
❑✓ General Permit Rules available at the following link: www.deq.nc goy/CAMArules
Authorized Agent I- - .,..L:,.,,) (, 1. �.. is 1 ):: ,\
Project Location (County): _ - ('. ,t r , 4 , - }-
Street Address/State Road/Lot #(s) 1 1
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City ZIP_ ', Iv,-7 j
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Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑y PTS Adj. Wtr. Body 1J c r..k h k 1 'J •", (nayrnan/unk)
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body l.) r, c I I,:
ORW: yes/no PNA: yes/no
Type of Project/ Activity
(Scale: I'c It, o )
Shoreline Lemrth
Access Length Pier (dock) length
son
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Fixed Platform(s)
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Platform(s)_
Finger pler(s):Floating
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Total Platform area
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Groin length/#
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A building permit/zoning permit may be required by: , , e I' . - l U t_ L r , , I ,.,A 4
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)
or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature **Please read compliance statement on back of permit"
Application Fee(s) Check p/Money Order
Signature
Issuing Date Expiration Date

Docusign Envelope I D: 5832EFD2-8278- 411-B902-7BB9F8AO8DO3
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: James and Brenda Zettervall
Mailing Address:
110 Rita St
Jarvisburg, NC 27947
Phone Number: 757-334-8644
Email Address: [e-mail]
I certify that I have authorized Emanuelson and Dad
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: construct new T tail x 81' long wood
bulkhead with 1-6 return
at my property located at 110 Rita St, Jarvisburg
in Currituck County.
I furthermore certify that 1 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:
L0o 5u nedby:
3 5-&, ,-4
Signature
Brenda zettervall
Print or Type Name
Title
8/8/2D21 1
Date
This certification is valid through

Docusign Envelope ID: 819A04C0-FD8C45CF-8FIB-FF9C4407A9A5
,, Marfae coeewctron & P7lin•conapcfor'.
Certified Mail — Return Receipt Requested
8/26/2024
Matthew Zettervall
22579 Verde Gate Terrace
Brambleton, VA 20148
Dear Matthew,
PO Box 448
Nags Head, NC 27959
Phone: [phone]
Fax: [phone]
We have been contracted by James and Brenda Zettervall to do the following work at 110 Rita St
Jarvisburc:
1. New 3' tall x 81' long wood bulkhead with 1-6' return
As the adjacent riparian property owner for both properties neighboring 110 Rita St, I am required to
notify you of the project in order to give you the opportunity to comment. Please review the attached
sketch for additional information.
We ask that you sign the attached Waiver Form and return it to us as soon as you can. You may scan
and email, fax or simply mail. If you have any questions, please do not hesitate to contact us. Should you
have any objections to the proposed work, you may contact a NC Division of Coastal Management
representative at 252-264-3901, or in writing to 401 S. Griffin St., Ste. 300, Elizabeth City, NC, 27909.
We thank you for your cooperation in this matter.
Sincerely,
Lorelei Barrett
Emanuelson & Dad
emanuelson6705rED outlook.com
www.emanuelsondad.com

Docusign Envelope ID: 819A04C0-FD8C-45CF-8F1 B-FFK4407MA5
Initial appropriate
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: James and Brenda Zettervall
Address of Property: 110 Rita St, Jarvisburg NC 27947
Mailing Address of Owner: 110 Rita St, Jarvisburg NC 27947
Owners email: [e-mail] Owner's Phone#: [phone]
Agent's Name: Emanuelson and Dad
Agent's Email: [e-mail]
Agent Phone#:[phone]
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adjacent Property Owner)
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
NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to what is being proposed, you must nary the tv.c. urvision or r,oasrat
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
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
Initialfsign appropriate Manh Signature of Adjacent Riparian Property Owner
-OR- InitlzI
I do not wish to waive the 15' setback requirement (initial the blank) I V 1 Z
Signature of Adjacent Riparian Property Owners
Typed/Printed name of ARPO: Matthew zetterval l
Mailing Address of ARPO: 22579 verde Gate Terrace, Brambleton VA 20148
ARPO's email:
[e-mail] ARPO's Phone#: [phone]
Date: 8/27/2024 *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021
Fill out and sign bottom portion