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TOWN OF BATH
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BATH-,.NORTH-CAROLINA-. . _.,: _... -_.. 1i+ :•' :`,: ,x...
BOOK NO: _._...._..v..r. PERMIT-FEE
APPLICATIONFOR: ••BUILDING'PERMIT ._ (.-..).-..-ZONMG-COW-LIANCE;CBRIVICATB__(/_r..
OWNER. __ - -' --
CONTRACTOR : -
DESIGNER
SURVEYOR
ELECTRICAL.- __....___...._. __..._.-_.... a�,.'_,t -+, -�:fi -`'-'•;:��
PLUMBING
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NEW() ADDITION() ALTERATION: INSIDE() REPAIR:INSiDE (} MOVE.( )
OUTSIDE O _..._: _.__v OUTSIDE O LOCATE,
Lot No. . Block No. . Building located at
between and Streets. Building to be used as
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crawlspace, number feet apart . I3eight of crawlspace under house: I T' ( ) 2411() other
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(Over)

George,
You may have already received the Riparian statements from our neighbors for our bulkhead/dock
work. The lot owned by Lori Weatherington has been sold and the transaction was completed on
Monday, Sept 11th. This owner statement should be replaced with the this one from Daryl Morris, the
new owner.
Let me know if you have any questions
Lewis

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: ao45 1st St
Farmville, IIC 27828
Phone Number: 252.228.0222
Email Address:
Jack Lewis Yelverton Jr. / Letecia Strickland Yelverton
[e-mail]
I certify that I have authorized George Linton (Linton Marine Construction)
Agent/ Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
Bulkhead / Dock J Boat Lift
at my property located at Lot 43 Glebe Creek Landing r
in Beaufort , 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:
Jack Lewis Yelverton Jr. / Letecia Strickland Yelverton
Print or Type Name
Title
08 1 25 / 2017
Date
This certification is valid through 1 1

MUJMl.CN 1 KIPMI'CIMIV PKUr=K I T UVVIVCK S 1 H I CMCIY I
I hereby certify that I own property adjacent to Jack Lewis Yetverton Jr. / Letecia Strickland Yelvelton 's
(Name of Property Owner)
property located at Lot #3 Glebe Creek Landing
(Address, Lot, Block, Road, etc.)
on Glebe Creek , in Bath , N.C.
(Waterbody) (CitylTown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loci
I have no objection to this proposal.
I have objections to this proposal.
IN. AND/OR DRAWING OF PROPOSED DEVELOPMENT �N
welopr»ent must, fill in :description bstow or_attach a_srte_ drew ng ,
- Approximately 150' of Vinyl -Bulkhead
- 40' Dock with 11'x20' Platform to Right
- Boat Lift to Left of Dock
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.
ln� Fdo not wish -to waive the 15' setback requirement.
(Property Owner Information) (Adjacent ProRerty►-O*ner Information)
i& �­
Signauire
S N,,;
Print or Type Name
Mailing Address
'1 . \W lA, \&�,;
City/State/Zip
Telephone Number/email address
Date
Print or Type Name
Mailing Address '
A C 27 F13f-
City/Stafe(Zip
9_6—g6 Fr-sr6s-�
Telephone Number/email address
Date *
(Revised Atla 2014)

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: Jack Lewis Yelverton Jr. / Letecia Strickland Yelverton
Address of Property: Lot 0 Glebe Creek Landing
(Lot or Street #, Street or Road, City & County)
Agent's Name #: George Linton
Agent's phone #: [phone] ! 252.943.7154
Mailing Address: 4229 HWY 92E
Bath, HC 27808
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 attache_ d drawing the development —
-��- they are pToposmg: ti descripfon or drawing: with -dimensions, must be provided with' this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 90 days of receipt of this notice. Contact information for DCM offices is
available at http://www.nccoastalmana-gement.netlweblcmlstaff.rlistina orby calling 9-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail
WAIVER SECTION
1 understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.
do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Jack Lewis Yelverton Jr. / Letecia Strickland Yelverton
Print or Type Name
40451st St
Mailing Address
Farmville, NC 27828
City/State&ip
252.228.0222
Telephone Number/Email Address
08252017
(Riparian Property Owner Information)
Sign tune
Douglas Harold Cushing t Martha Cushing
Print or Type Name
121 Glebe Creek Landing RD
Mailing Address
Bath, HC 27808
City/StatelLip
252.923.0292
Telephone Number/Email Address
Date Date
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner- Jack Lewis Yelverton Jr. / Letecia Strickland Yelverton
Address of Property_ Lot tit Glebe Creek Landing
(Lot or Street #, Street or Road, City & County)
Agent's Name #-. George Linton
Agent's phone #_ 252.923.6191 1252.943.7154
Mailing Address- 4229 HWY 92E
Bath, HC 27808
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 have no objections to this proposal. I have objections to this proposal.
Ifyou have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http.lAvww nccoastalmanagementnet(web/cm/staff-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
1 understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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.
do not wish to waive the 15' setback requirement.
(Property Owner inform tion) ('parijan Property Owner Information)
��Signaturof Signature
Jack Lewis Yelverton Jr. / Letecia Strickland Yelverton
Print or Type Name
40461 st St
Mailing Address
Farmville, HC 27828
QtylStatelZip
262.228.0222
Telephone Numberl Email Address
081252017
Dare
Lori C. Weatherington
Print or Type Name
100 Williamsburg Road
Mailing Address
Washington, GC 27889
CitylStatelZip
252.975.2133
Telephone Number/Email Address
Dare
(Revised Aug. 2014)

Lot #3 Glebe Creek Landing Proposed Development
-Approximately 150' of Vinyl Bulkhead
- 40' Dock with 11'x20' Platform to Right
- Boat Lift to Left of Dock
ROAD iPR ME J
S 670- 42'-WE

Pat McCrory
Governor
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Donald R. van der Vaart
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.
i. 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.
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.,
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 provided is complete and accurate.
Agent or Applicant Printed Name
Agent or Applicant Signature
CAMA GENERAL PERMIT #:
Permit Officer's Signature
Issue Date
Washington Office Morehead City Office Wilmington Office
943 Washington Square Mall 400 Commerce Avenue 127 Cardinal Drive Exit.
Washington, NC 27889 Morehead City, NC 28557 Wilmington, NC 28405 3845
Phone [phone] Phone [phone] Phone [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/105/o Post Consumer Paper