70677B_Single Pile P.W.C wing_20180309

.. CAMA /. El DREDGE &FILL � � 71_ YVQ N2 706 / 7 A C D
GENERAL PERMIT Previouspermit# 14 �A
New , ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit.issued r► A/V
As authorized by tt a State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC C7) Q
[7,Rules attached.
Applicant Name Project Location: County _T�ZA—I f,6-0- w
Address % 4- % C eO� 4-1 A Street Address/ State Road/ Lot #(s) 1-N C�—
City State >-A C-ZIP 27 `6�"� ) �'� C��-1 IM
Phone # 1�1 'r-Mail Subdivision C /el- T-4-
Authorized Agent n-�Z1`7 City ZIP
Affected ❑ CW ❑ EW . �TA ❑ ES ❑ PTS Phone # ( ) River- Basin I�L'��ML'' J
OEA HHF ❑ IH UBA N/A
AEC(s): ElElEl❑ Adj. Wtr. Body '��� G�--��. .(nat man /unkn).
❑ PWS:
ORW: ,yes / no PNA es no Closest Maj. Win Body
No
M.
yes no
tos: yes
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or Applicant Printed
Signature v"* Please read corlipM ance statement on back of permit
wy
Application Feels) Check#
Permit_Off er's Printed Name
s
SignaL6re --
Issuing Date Expiration Date

WOOL '04
Applicarti~ F F IeA
Pennftt —jcn C--1-1 y
Date: MF�2a�}, z-a VK '
Describe laeiawthe HABITAT disturbances far the application• Ail values should Faith the mane, and 6rufts of measurement
found in your HabU t code sheet ,
TOTAL Sq. 5'
FINAL Sq_ Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anadpated final
(Applied fort
(Anticipated firW
Habitat mama
DlSTURB•TYPE
Oisturliance total
dfsUbance.
DisWd bartcg
disturbance,
.'
Chndse One
includes any
Excludes are
total includes
Exfudes any
an
reitoraf r
any anddpated
reaiaraffan and/or
restoration or
amdlor temp
restoration or
temp impact
tamp hip -acts)
im oact amount)
temp impacts)
amaunl)
L.•�-r �,�
Oredge Q ' Fill [j Both. Q UfterlR
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40 ^ �
Gfedge; Q , Fri € Q Bath 0 Other Q
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Oredga-Q• Fill Q bath Q Other Q
Dredge Q ni(I [j Bath Q Qther Q
Qredge [[ Fill Q. Bath Cj other [�
rill Q Sala f�f Other [[
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7T�Dredge

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: 6
Phone Number:
Email Addres".�� o� caw•_
1 certify that I have authorized��
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at
in County.
1 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:
Signature
Print or Type Name
Title
03 / (Nq / ate 9)
Date
This certification is valid through / /

TOWN OF BATH
BATH, NORTH CAROLINA
DATE 3' 1' 15
BOOK NO. PERMIT FEE PERMIT No.
APPLICATION FOR: BUILDING PERMIT( )
OWNER
CONTRACTOR
DESIGNER
Name & License No.
ZONING COMPLIANCE CERTIFICATE ( )
Address:
4j 4. 0e,
TYPE OF IMPROVEMENT
Phone No.:
NEW (✓) ADDITION ( ) ALTERATION: INSIDE ( ) REPAIR: INSIDE ( ) MOVE (01�
OUTSIDE( ) OUTSIDE( ) LOCATE( )
Lot No. Block No. Building located at /9-6 Pf Pd,
between and Streets. Building to be used as
eMCo%on,
TypS iw �� 5 ;�+C'f o
Number of off street parking spaces . Contains P rooms and X 141
bath(s).
Total square feet of building . Electric Service . Type of heat
. No. of plumbing ftxtures . Foundation block caps
4" ( ) 8" ( }. Comer bracing: Plywood ( ) other . Insulation: Floor
Walls . Ceiling . Windows: Storm ( ) Thermal ( ). How many exterior doors.
. Water Heater: Gas ( ) Electric ( ) Other
Roof Ventilation: Gable ( ) Eaves ( ) Lowers ( ) Other Ventilation
crawl space, number of feet apart . Height of crawlspace under house: 18" ( ) 24" ( )
Other . Zone . Water and Sewer Tap: Paid ( ) N/A ( ) Size water tap
Size sewer tap: . Total Estimated Cost Flood elevation

BUILDING INSPECTION DEPARTMENT COMMENTS:
GENERAL COMMENTS:
CITY LICENSE NUMBER:
Contractor/AC Electrician Plumber/Heating
3
Application approved by: ,t/ -� $/ 8
The ner of this building and the undersigned agree to conform to all applicable laws of the Town of
Ba orth Carolina.
A�4
S' nature of AP611cant
Effective 8/10/04, there Is a $50.00 filing fee for all permits, including zoning compliance application.
Any construction that requires installation of water or wastewater services may:
A) Be installed by owners, contactors or
B) Be installed by Town of Bath Utilities Department
All components must be compatible with existing water/wastewater materials, including Myers pumps.
Bath Utilities Department must inspect all construction prior to services becoming operational. Inspection
fee is $100.00.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 's
r, (Name of Property Owner)
property located at
Ste$
(Address, Lot, Block, Road, etc.)
on A~rv, , in eAcrv\ , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
, _ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
�lnre�d'�rr��=proposi��%�e���lo�i�»�t���r�usi,XO°ra�escr��oelaw,zct� a�����s�te,;�r�i�v��g)
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WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boatho se, lift, or groin
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.
Y. I do not wish to waive the 15' setback requirement.
(Property Owner Information)
(Adjacent Property Owner Information)
atu
Signature*
tUt eel AQ
Soy stem. n�-_u U tz
Print or Type Name
Print or Type Name
t4b A' .-c s 7
114e, 0rc,wax
Mailing Address
Mailing Address
+� �y �/
t-IC- '7--T 0 �.3 .3
�t �r [,
-LAW.. i- C °- l OQ q
City/StatelZip
City/StatelZip
q45- 7497
56 % +�-
Telephone Number/email address
Telephone Number/email address
AL- .-y3 -- 1O t92
a -,*I - 'Aum
Date
Date*
'Valid for one calendar year after signature" (Revised Aug. 2094)
s

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to St o;mv !k �w;LL xaa Mc 's
(Name of Property Owner)
property located at ti ►y* GaY4,,W ?v-Z- 15i6
(Address, Lot, Block, Road, etc.)
on Sm-4s Ccze�rt , in SATI'L t-x . , N.C.
(Waterbody) (City/Tcwn and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
C I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must flit in description below or attach a site drawing)
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WAIVER SECTION
I understand that a 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. (If you wish to waive the setback, you must Initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
X I do not wish to waive the 15' setback requirement.
(Property Owner Information)
a e
Print or Type Name
lob —]?IV. "L2A
Mailing Address
ti a-
City/State p
35 a - cW7- s-w A -
Telephone Number/ email address
a- 3KS- aot�
Date
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
a
An 4
Signature*
SJWW MAe�2 a.�+s NL s E
Print or Type Name
Mailing Address
_14-m . "C 3- 1:r b It
City/State2ip
Telephone Number/email address
a -
Date*
(Revised Aug. 2014)

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BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
ROY—.GOOF.ER-
10OWW"
'MI GHA"I L S. RExGAN
- stWetaty
BRAXCTON DAVIS
�cctot
A riparian buffer authorization is required for pier and docking facilities access Ways through the_ Tar -Pamlico &
Neuse River Riparian buffer per Division of Water Resources (DWR) regulations 15A N,CAC 026.0233 & .0259. The
Division of Coastal Management (DCM), through a Memorandum of Understanding with the Division of Water
Resources (DWR) has reviewed your project proposal and has determined that the project as proposed complies
with the aforementioned regulations. .
Those activities covered by -your Coastal Area Management Act (CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions listed.below. Failure to
comply with this Buffer Authorization may subject the property owner and the party (contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to $25,000 per day per violation.
1. Crossing is Perpendicular: Pier -and docking facility access way must cross the 50 ft. riparian buffer
perpendicularly (which -is defined as between 75 and 105 degrees) unless otherwise approved by DCM. The
alignment shall minimize the "removal of woody vegetation to the greatest extent practicable.
2. Pervious Materials: All reasonable measures shall be taken to ensure the access way is made of pervious
materials like open -slatted wood or'composite, mulch, or grass to meet the intent of the rules to the
maximum extent practicable.
3. Access Width: The width of the pier or docking facility access way shall be limited to six (6) feet.
a. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing of your
property indicating the relative location of the pier or docking facility and any requested access way. This
drawing will be used to aid in compliance and monitoring efforts.
• Pre -project site conditions:
By your signature below you agree to be held responsible for meeting all of the conditions listed above and verify
that all information-grovidecps complete and accurate.
j
f
AT 11 Tbr-A pplic n Pr' d Name
ge t or Apphca gnature
CAMA GENERAL PERMIT #: -7d G­)-
mit icer's Signa re
Issue Date
State of,North Carolina I Environmental -Quality+ I CoastalManagement
WaasMngton Oliice 1943 Washington Square Mall Washington, NC 27889 f 252-946-W- 1
Wilmington OMcb 1127, carftal Qri>re.Ext. Wilmington, NG 28_ 0$-3845 I' %o-Y9ti-' 218
Morehead City Office 1406commerce Avenue Morehead.City, NC 28557' 1 252-868t26M