64100_Matthew White_20190409

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_ )/GENERAL -PERMIT ,-lD `... Previous: ermit'#- ., i_1 .ice '..
j New, ❑Modification .dComplete,Reissue Partial Reissue • . - - •--'Date previous'permit`issued -,' ''''N.--1a `., `
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 5A NCAC ' D-71-'• ' /2 �` 9--"'.`- , • ' - ' •- .. -
l [Rules attached.•'
Applicant Name 44,1, -7.l w •k.)/--).-/1 �7'I , L-,41u'5fiLit.Project Location: County' 2572 4`1.;-;•f J%2i: • ld.. - '
Address 3.3 75: .44 TZ c7-15 .• 1A✓4`7 • ' • , Street.Address%State Road/Lot#(s)"DpF`� $Z- ,3- 5' ., ;'
City -Z3' 7-1 ' , ' State'f-1 Z.—ZIP;? iz_'7 D . (0 333 ,KAi .�I.:S -+Gi id-%, ' -,
,.Phone,#;(:i S 2)-(p(G( . 2-7 DE-Mail - . Subdivision IJ 1! ' '
Authorised Agent' -/`7 i , . - City 7 A-r -/ ZIP "2--7 ` `6 -
.❑CW• ❑EW PTA •❑ES` - ❑PTS -• Phone# ( ) River,Basin 7 1Z— ?hvi,-/ram'
Affe•cted ❑oEA ❑HHF ❑IH , CIUBA ❑N/A
'• AEC(s): Adj.Wtr. Body -I G1z.��--: ' (nat /man /unkni ,
❑PWS: _
ORW: yes / no PNA yes /fin) Closest Maj.Wtr. Body Pf1^'�`f - �I .t uCy�
Type of Project/Activity /,_I 4-r�z_t i c) A / V- Pt 11 c F4›o7•^'\ . . - - '
(Scale:I �_ v' - )'
Pier(dock)length -
Fixed Platform(s) j ''�, �I G 17%�� I . --�7 "� 1 •
'Floating Platforms) /a Y•l C�'- 1
Finger pier(s) ;
Groin length �lJ 1 -
number ' -• I
t1 I -
Bulkhead/Riprap lengthr $ I • ' ,
avg distance offshore - ' I ,
max distance offshore a-----t R) I
•
Basin,channel •• h LI% I I '
., n,ra .,)I ,P,nrr7-N24 GA I 'f. .
•
- (e-i�-re---� i) -/-.44-- '
- cubic yards • I '
Boat ramp I1 I �"f-•--�- O' - • I
I j -
Boathouse/Boatlift 1
I '
Beach Bulldozing —IT"
-
Other /O rY(U if4-,rl:-. _::v
/ '.
Shoreline Length i i30 I I f -_
- SAV: , not sure yes no ./ I - •
. , Moratorium: n/a yes QV r _�.. - 1
Photos:• yes no i'-` .-0>' `� �-e?I
r , Waiver Attached: - yes 4, '"`��e,4 . 1.- c17r,F
A building permit may be required by:TO '4-1 D 7 q -.1— . See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions —?•D sv,/ p ' -r3 l- "ZbAiI(1,„ (arvi pi.o -!•G3--- „s-5-1-- f-f.Ez-,0 • ate' '- -1 ice'
1 h P�Qe)S-� S`%o r,,2' a r- Pi4- 4yt.--\ �,r"%`YP/1� ,4 o-t eo 5?0 O-( -- . - , ,
Agent or Applicant Printed Name, . Pe mitOffi✓cer's Printed Name
C -
Signature- **Please read com-plian. a statement on back of permit** Signat re . , /� ) �t
l( C 11 r '2.a r'`r''' i 2e ","'_ 1 Apia-1 i -•a D 7 Cj c L°�`'1 i i'f",I / 1 •
Application Fee(s) - Check# Issuing Date • , i - ' Expiration Date v

- ROY COOPER
Governor
•
MICHAEL S. REGAN
•• Seaetaty
Coastal Management BRAXTON DAVIS
itiviROSiiitEdrACQUAlaiy Diteetof
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 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.
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: . p
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 comp) nd accurate.
•
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Agent r Applicant Pr' me • •.tj.it O'*'= s 5;, e
•
- 7/g/9-77/Z //-77 g &.,
Agent or Applicant Signature Issue Date
CAMA GENERAL PERMIT#: 24717
State of North Carolina I Environmental Quality f Coasta[Management
Washington Office 1943 Washington Square Mall Washingtonn,NC278891252-946-6481
Wilmington Office 1 127 Cardinal Drive Ext.Wilmington,NC 28405-38451 910-796-7215
Morehead City Office 1400 Commerce Avenue Morehead City,NC 28557 1252-808-2808

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: MATTHEW WHITE ,
Mailing Address: 333 KARENS WAY
BATH, NC 27808
Phone Number: 2526612700
Email Address: [e-mail]
I certify that I have authorized DAVID ANDERSON/EZ DOCK
Agent/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: JET SKI PORTS
at my property located at MOORE LN. BATH, NC 27808
in BEAUFORT County.
l 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:
7 att/wAr Gt%Z
Signature
MATTHEW WHITE
Print or Type Name
OWNER
Title
12 /28 /2018
Date
This certification is valid through / /

Name of Property Owner: V-AcV\A"Nkc-' ,...).-,) \ O
....,
Address of Property: -4-1tD Pdzo_ LI,), 15r-tilk , t, IC -F:kfILL:7fs r rut ri-‘4
(Lot or Street#,Street or Road, City&County) -
Agent's Name#: Mailing Address: s.
Agent's phone#:
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 drawirig_the development
they are proposing. A description or drawing with diMensionS, must be provided with letter.
f,, >
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have no objections to this proposal. L' V-544)1 have objections to this proposal, ,
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,.' If you 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
ts 4 , available at htt :ii w.nocoastalmana merit nethireblemistaff-Ifstin or by calling 1-888-4RCOAST,
No response is considered the same as no objection if you have been notified by Certified Mail.
,
. ,.,) 42 -,-,,,
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WAIVER SECTION
)t,l) ...;4' 1:,
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must ,-
P ',, be set back a minimum distance of 15 from my area of riparian access unless waived by me. (If i
you wish to waive the setback, you must initial the appropriate blank below.)
„ 1
m.rf,Vi$,V:,-W ':,,,, I :I7
V-STAk,,,An‘'orn l do wish to waive the 15' setback requirement, , a„...
---
g'',7 42,1w4,14."40 I do not wislito waive the 15'setback requirement.
(Property Owner information) (Riparian Property Owner Information)
Signature Signature
t-iti:1\-M-6-:t I ) k.),:).°0‘Vtli, 774ik.064W1444:44"1'A .
Print or Type Name Print or Type Name
LA X4
Mailing AckiresS Mailing Address' i
li'tik.N k< V.- 2:1%:-CA Mi,:ii'i"Vii. :'-' I lfgNPlaWiq
City/State/Zip City/State/Zip
(2. ')'\(All '27 GO i'l t-,h 1:if-5-,n4i tr,rx-rtt(4-16rvi ' :,'- '-:)-5-,•,-;-,:''',.,'-4 4:-ir;):,:::-,s,i,fa,,-ic n;,4-ij
Telephone Number!Email Address ) i',"4:40 Telephone Number!Email Address
Date Dalt!.
(Revised Aug. 2014)
. .

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SF. LER COM�L � hJS 5 � i�r�O � S. a ET'E 'NS; E� TI4/JOI�O ro �e�9 .
Complete items 1y_2r and:3. A•'aSignatu s `
'Print your name and address on the reverse x ". 0 Agent-
so'that we can return the=card'to,you.` = 0 Addressee
p -
Att&CFt this CaCd tt7-the back of the m>�ilpiec®, '� • ` -elved•by(PrintedName) r .Data of Delivery
�
. • `•>,oron the front if space permits, - fy'e12-'P,�t r 1,,,?„ ' v` / "-tEe:-/
f. Article Addressed to: D.ast`delivery address differentfrom item.? 0 Yes
\r��� { g - �" If YES,enter delivery address beloud: Ii No
•�111111111 111 1111111 111 0 Adult ui7iS gn turee Restricted DellverY' '�0 Reg(t red Mail Restricted
9590 9402 3777 8032:310719• ❑Codified Mall® Delivery. •
0 Certified Maii Restricted Delivery 0 Return Receiptfdr•
- ❑Collect on Delivery , ,Merchandise'.
2. Article Number rc'nsfer from service Welk— g,plied gn,Delivery Restricted Delivery 0 Signature ConfirrnatiannA '
CT Signature Confirmation
7 018 1830 0 0 0 17702 1394 /eatdcted Delivery Restricted Delivery
PS Form 3811;July'2015 PSN 7534-02�000-9053" Domestic Returrn Receipt ;l

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Dock Live Load of 62.5 lbsisqft MADE IN ,,
Low Profile Dock Live Load 30 lbs(sgft • USA '
e
9'-9" 0,0 ryas oc
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FA AI
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1 loll
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14' �oject Name:
i Filikill I
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Distributor Name:
David Anderson
e yT< • I ro •• I I •
E7.Oock3oiutions
. (252177311791
.R r$� Drawn by:David Anderson
t' '�.R•,e,';^,",A'„�=•� ' Date:,2r2R'2oi$
c, F i{ 000_43462465922
ti�+ .z4'. �' DWG Name
EZ Dock,Inc
878 East Highway 60
-- Monett,Missouri 65708
' Phone:I(800)654-8168
• • roc:[phone]
•
General Notes:
I This eor/chomp,.cg does not reflect Once safticient information&
completed Proposal Request Form consuming water and bottom conditions
is received.anchoring may bn detailed.
1
2. Note:It is the dock owner/operator's responsibility to°soared°and amply
with all applicable Federal,State,and local laws.ordinances and
regulations as well as all inspection.ptmanmg and lionising requirements
pertainmg to the installation,application and use or CZ Dock products on
the ensues/epctates promises,El Dock,Inc.MIMICS no duty or
responsibility with respect to the legality or compliancy of the
owner/oprarot'ts chosen inuallotian,application or use of EZ rack
• NOTICI31 Read EZ Dock Limited Warranty carefully.Among other things,EZ Duck does not warrant damages, produaa
failu rs or defects caused by unauthtinzed modification of EZ Dock Product,maim unauthorized attachment to'of
P2 Dock Product, _ --`L`— — ..../ 3. References EZ Dock Manual Chsr nrml fnraddicinaal derails.
----_� ...")
—
/

BOOK NO:
PERMIT FEE PERMIT No.
APB
LIGATION FOR: BUILDING PERMIT( ) ZONING COMPLIANCE CERTIFICATE ( x )
Name &License No.
Address: Phone No.:
OWNER
MATTHEW WHITE 333 KARENS WAY, BATH 2526612700
CONTRACTOR SAME
DESIGNER SAME
•
SURVEYOR
ELECTRICAL r
PLUMBING
TYPE OF IMPROVEMENT
ALTERATION: INSIDE ( ) REPAIR: INSIDE ( ) MOVE ( )
NEW (� ADDITION ( ) OUTSIDE( ): OUTSIDE ( ) LOCATE ( )
Building located at 476 MOORE LN, BATH
Lot No, _ Block No.�—
between
and Streets. Building to be used as
. Type Construction JET SKI FLOATING DOCK
rooms and bath(s).
Number of off street parking spaces____. Contains ,
126 .
Total 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 crawlspace under house: 18"( )24"( )
Other__
Zone______.Water and Sewer Tap: Paid ( ) N/A( )Size water tap
Size sewer tap:
Total Estimated Cost . 9 Flood elevation

5frf/L/Zf..k. p Eit. I E1.14 Two. £ D47
tr I F T" v N i 612- . Au- 5Fr75..4Q.s £ AJ s is TEArr
1 LtiSI .547 I/V 1� .•
GENERAL COMMENTS: --gQ 4 4.S4 . opproia.' tA.,s•cx.1l C41 Crc a'
J,e1V5k,► -Qld r1.(16 0I.vcLC..
CITY LICENSE NUMBER:
Contractor/ Electrician Plumber/Heating
Application approved by: 1 ifr--
The owner of this building d the undersigned agree to conform to all applicable laws of the Town of
Bath, North Carolina. "
7 1a d 1-u)iia
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.

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Applicant: lt/wrTtfew ,-re /pi,* N w3024
Date: 9 el-Pat L_ 19
-General Permit#: 9 g_7_5
Describe below the HABITAT disturbances for the application: All values should match the name,and units of measurement
found in your Habitat code sheet.
TOTAL Sq.Ft. FINAL Sq.Ft. TOTAL Feet FINAL Feet
(Applied for. (Anticipated final (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
Habitat Name Choose One includes any Excludes any total includes Excludes any
- anticipated restoration any anticipated restoration and/or
restoration or and/or temp ' restoration or temp impact
temp impacts) impact amount) temp impacts) amount)
14/ rz: Dredge 0 Fill 0 Both 0 Other r 1 44.0 ft- /etzr, '
Dredge❑ Fill❑ Both 0 Other 0
Dredge❑ Fill 0 Both 0 Other 0
Dredge❑ Fill❑ Both 0 Other 0
Dredge 0 Fill❑ Both ❑ Other 0
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge 0 Fill❑ Both 0 Other 0
Dredge 0 Fill❑ Both 0 Other 0
Dredge 0 Fill❑ Both ❑ Other 0 €
• i
Dredge 0 Fill 0 Both•❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑ _
Dredge 0 Fill 0 Both 0 Other 0
Dredge 0 Fill 0 Both 0 Other 0
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