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the State of North Carolina, 136partrrienti,bif Environnrient and, Natbral Resources
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DATE ���2
BOOK NO. PERMIT FEE PERMIT No. 64
APP ICA'nON FOR: BUILDING PERMIT( ) ZONING COMPLIANCE CERTIFICA 1 E (✓ }
Name & License No. Address: Phone No.:
.ail _ S /a r�'%'�oo.� S Me")
OWNER
CONTRACTOR
DESIGNED.
SURVEYOR
ELECTRICAL
PLUMBING
NEW ADDITION ( ) ALTERATION: INSIDE( ) REPAIR: INSIDE ( ) MOVE( )
OUTSIDE( ) OUTSIDE( ) LOCATE( )
Lot No. Block No, Building located at ,,/A�Q_ 4M lf:
between and
Type
Number of off street parking spaces . Contains
Streets. Building to be used as
rooms and
U
bath(s).
I otal square feet of building Electric Service Type of heat
No, of plumbing fixtures . Foundation block caps
4" ( ) 8" ( ). Corner bracing: Plywood ( ) other . Insulation: Floor
Walls , Ceiling . Windows: Storm ( ) Thermal ( ). How many exterior doors.
Water Heater: Gas ( ) Electric ( ) Other
Roof Ventilation: Gable ( ) Eaves ( ) Louvers ( ) Other Ventilation
crawl space, number of feet apart . Height of crawispace under house: 18" ( ) 24" ( )
i
Other Zone . Water and Sewer Tap: Paid ( ) N/A ( ) Size water.tap
Size sewer tap: . total Estimated Cast Flood elevation
BUILDING INSPECTION DEPARTMENT COMMENTS:
PLAMS Ss4aw _(9 STAL A-n ect mE ! v , T-%uLjJlkAA
"MF-- I-04Ar wi wIL- B� �6t7A4u),ogA: '8•1 COMA oaGi[�tt
aa..rc DA) :5,rr,y!srt'
K16 4'!"AA-)6ES -*b 't7r Z.
CITY LICENSE NUMBER:�ekl-
Contractor/AC
Application approved by:
Electrician
Plumber/Heating
The owner of this building and the undersigned agree to conform to all applicable laws of the Town of
Batf North Carolina.
c
Signature of Applicant
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.
MCDEMR
North Carolina Department of Environment -and
Division of Coastal Management
Pat McCrory'
Natural Resources
Donald R. van der Vaart
Governor Secretary
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
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 NCAC 02B.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 .
as long as 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 & the party (contractor) performing the .
construction &/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 accessway 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.
4_ 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.
s Pre -project site conditions: wN
By your signature low you agree to be held responsible for meeting all of the conditions listed above and verify
th II information rovi d is complete and accurate.
P Al'5
, '0
peg or Applicant Pri9ted N;fne Permit O r is Signature
or Applicant Signature
CAMA GENERAL PERMIT #: G 13 9
L Dom_ Zv 1 -3)�::
Issue Date
Washington Office Morehead City Office Wilmington Office
943 Washington Square Mall 400 Commerce Avenue 127 Cardinal Drive Ext.
Washington, NC 27889 Morehead City, NC 28557 Wilmington, NC 28405 3845
Phone 252-946-6481 Phone 252-808 2808 Phone 910-796-7215
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper