74069_Kenneth Davis_20190917

�CAMA / DREDGE & FILL To4 (p�.139 No. 74069
A B C D(
GENERAL PERMIT Previous permit# A/ ► 4
. - New Modification -_Complete Reissue Partial Reissue Date previous permit issued ,•/ //i,
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 15A NCAC /---� ' ,
Rules attached.
Applicant Name 6..//-/4-- 7-J `.)A I, ,> Project Location: County ii3,--/-t,A—z; -c' ,
� �� -7-*c_r, 47 7z�
Address .4 t7 S' - - .1-‘44.4-E---- Street Address/State Road/Lot#(s)
City//—e`Y ✓i/ c.r' State i'---/t' ZIP Z.-7 'S c .' 7 ,t-/A-„J ' "Da', LT- /AS-,- =
Phone#(' 2) ;� -5 Z 9 cg-Mail Subdivision ,,. 7--
Authorized Agent 2 eTiCK,6 Zs,•-}7-z,J City )--7-A-'/ ZIP c•-)`'
Affected ❑CW ❑EW PTA ❑ES ❑PTS Phone # ( ) River Basin j 2 't'\noc i e-U
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC s ; Adj.Wtr. Body !.�� l�t= Knatiman /unkn
)
❑ PWS:
ORW: yes / no > PNA yes / no / 'Closest Maj.Wtr. Body ' �"1 L'' !� '!J�=
Type of Project/Activity,.-- F-fi ( /3 v �� 5 N�- ems- /.V,
(Scale:/ ;-3) )
Pier(dock)length-
) i : I ME ,
Fixed Platform(s) � 1°
Floating Platform(s) I iMgirta••i.WM i
Finger pier(s) I MRIMMIIIIII.n..MEIIIIIII
Groin length /
'number \
� EIME Bulkhead/Riprap length 14)3zj RU� t . _MIM --` I a'
avg distance offshore `a 1111_IIIII —
max distance offshore Z.`' 1=11111111111Ft.K� IIIIII= '
Basin,channel C11141 II„IIINIIIIIIIWAN®_—•
.)
IIIIIMIIMINr �III IINMIIIMIIIIIIIIIMIIIIIIIIIINIEIIIII
N NUM=
cubic yards �'I - 1nui.I� M ■■
Boat ramp
5:21MIMIIII—IMIMII IIIIIII_
Boathouse/Boatlift ill =riamomommeim .
__ —_
EI
Beach Bulldozing IMIMMMEMM N
EMM '
V_=NE IN MINN
Other =U— _S—�
r�r� —,®
, L_In...,:64......w.miksi ' NMEENJOIE -
Shoreline Length__ /30 gli _ MMili
SAV: not sure yes no En
, i .1101 1,_ , ...., ¢-
Moratorium: n/a yes ,,:no ®_M_R_•R '
Photos: yes I RU �,—����•rr—= U
Waiver Attached: yes :' no
RU W.MI JE
A building permit may be required by: / v(,✓r/ O T 4N . K See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions rDL✓ • D,-- 11-1y' 7 v>L/,r-1 C0/"1 PI- -Z,`-< y i
( e U ( 6 ( L / Al 7 b i's.N :/ �P,y ,.,
Agent or Applicant Printed Name i Permit Officer's Printed Name
L/4/4 /
Signature **Please read compliance statement on back of permit** Signatur
p t 1/4- 5' lA / 1 1. - 24) / J,�...1,,,,',_,-,
Application Fee(s) Check# Issuing Date Expiration Date
,i

Authorized Agent Consent Agreement .
I k(cK. .4 4.✓, ,hereby authorize G a✓1 e L s 4. . to act on
(pay owner) (Authorized Agent)
my behalf in obtaining LAMA permits for the location listed below.
•
Property Address:
lit3 E' (411', ( -�
Property Owner's Mailing Address:
L 45,Clr {2�
{ � h „ �( ,(/ ( . 27 yrf
Property Owner's Signature'
ignat u :: / G�
Authorized Agent Signature:
Date: l /► 1�/ I
2 $ L 7 �' g - 5 Z14

e NA/ A U/ S
I booby coat lb* ova Ms**mats (\fill-U.11? 'a
(Now eflitopoiy Mao)
prepay l000d at
gat Block 204 co.)
CR in
(ThilidN1161 saw County)
lbotoitalabloambeillom sawn billioosibeiks
poposolatiloalovellooMbo. Indoolomillotawasofinekso,osobolos
bollibmik wails atiodkooidomodbmwooillibonfuottnnfontow
oridipods anus alloombooll*vitt
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I Wow dirolake gpicgtiggropoogd bade wraith*Dwain
the(W)sibs*solobiliest
i to oideabo to Ibb potfoo praposol ad&gob 4o min do
OP)outback ogoionsoot.
•
I olfootlo Iborolott so propood.
onsaiorriON merataumnicumnarossorevaavanwr •
(Woes"tab,bdivibidpoosioidwidoper )
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Print or Tyrolean • Moot=
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I herebyow**el mrspeopeatl►Oirounts
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Modmily1 ,aedliarOnsty)
asirwieir~esis
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iballemftimitItsseabwksallimiimearilimebitfinesetsw
aina atziporion antis eeiaesimilueiiy►a�e�
I iem Ognipotafp redbetdo salvia waive
limns.*Was is entiontion us premed EA&midi**sin tbe
I**at to Ibeintiotal ow.
•
O 1i0N1Al DIA LK001 DLIIVELOPMENT
(re beSlMi isib iieelarepeeleedrwiopmak)
t -;A ti "/Y 17/-
Print orilypsaeme
77 ( cih7)/ 7
Tchoime Date

TOWN OF BATH
BATH,•NORTH CAROLINA DATE /�e/ .
BOOK NO. PERMIT FEE PERMIT NO.
APPLICATION FOR:'BUILDING PERMIT ( ) ZONING COMPLIANCE CERTIFICATE ( )
NAME&LICENSE NO. ADDRESS TELEPHONE NO,
OWNER " N 7 /1 17,L1 0 .7S
CONTRACTOR 6—C' e .l/V 70A
DESIGNER •
SURVEYOR
ELECTRICAL
PLUMBING '" •
TYPE OF IMPROVEMENT
NEW( ) ADDITION ( ) ALTERATION:INSIDE ( ) REPAIR INSIDE ( ) MOVE.( )
OUTSIDE ( ) OUTSIDE ( ) LOCATE ( )
Lot No. . Block No. . Building located at it/U P I Zdek4/,c
between and Streets. Building to be used as
. Type construction )3 i 'is K j 1 (,4)
Number of off street parking spaces . Contains rooms and bath(s).
Total square feet of building . Electric service • . Type of heat •
. No.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
crawlspace,number feet apart . Height of crawispace under house: 18"( )24"( )other
. Zone . Water and Sewer Tap: Paid( ) N/A( ) Size water tap
Size sewer tap . Total Estimated Cost . Flood elevation
(over) •

NC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant: 64 ti6TOt '%%v,S
Date: /7 ��hd� 020/ '
General Permit#:71/(6 9
Describe below the HABITAT disturbances for the application. All values should match he name,and units of measurement
found in your Habitat code sheet
TOTAL Sq. Ft. 1 FINAL Sq, Ft. TOTAL Feet FINAL Feet
(Applied for. (Anticipatednnal (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 tern p restoration or temp impact
temp impacts) impact amount) temp impacts) amount)
thole Ira. , I 10
3
� Dredge❑ Fill❑ Both ❑ Other
1 // ki V
n�' ar Dredge❑ Fill Both ❑ Other ❑ .26 6) v260
a-044, Dredge❑ Fill❑ Both ❑ Other [+� C/V 17.0
Dredge❑ Fill 0 Both 0 Other ❑
• Dredge❑ Fill❑ Both ❑ Other ❑
II
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑ I
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑