74097_Susan Webb_20191028

/62.
CAMA/ ❑DREDGE & FILL Z1% VLg tf1g No. 74097 A C D
GENERAL PERMIT Previous permit# /.J J/
��% al New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued A.' /A4-
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�'u „4r.1 ln)E1). .%T �r
Project Location: County �,,a , c- r fT '
Address .Ck�D3 A L/4.�; - 4 v= 7`_' ‘.a--1 • Street Address/State Road/Lot#(s)
City /. - Q State/-1G ZIP 2 7 /J1 J - .
I' Phone#( Z.-) :3 ,- 76-4tic-Mail Subdivision "'\ -' .--.=7=-
Authorized Agent %�n.,,,.. p L7 i,'r ,- I -, City ,''\ fi 7J' ZIP `") f''!- 7'
Affected ❑CW ❑EW [RTA ❑ES ❑PTS Phone# ( ) River Basir7\2 d n"''' -/(0
:� AEC(s): ❑0� ❑HHF /❑I\H ❑UBA ❑N/A Adj.Wtr. Body 2 "I ;'`�-.�. 2 r� (n3tr2/man /unkn)
Closest Maj.Wtr. Body
ORW: yes / no PNA yes / ric-
-1
i
Type of Project/Activity /3 x / . ' z-s l(<?'-'4-71 e i7 dam--r-i_, t-T
(Scale: / .-Jo ' )
Pier(dock)length l 1 f
Fixed Platform(s) �.► I� i
Z..�t,-4 7 , '—t
Floating Platform(s)
4
Finger pier(s) I I
Groin length 1. ---- 1 N -
$ number I
Bulkhead/Riprap length
avg distance offshore ! "%nor., I
max distance offshor 1
I Basin,channel _ ,$1-1 4— t,
� ��
l
cubic yards 'I OUNIA j • a
Boat ramp 4'.'?5 ry--, t-
1 j ) /"t
- 610Z9 i, i- E.-C.) /
Boathouse/Boatft
• ti'-"T2 I r'/"'
0 ,
Beach Bulldozing --i
Other ! . 41
l
l —. T
3 Shoreline Length _..› , ! ( 4 ,..--
i:::
yesJ —{ .._..-....._yes ,..[. .
yes ,o Jtyj,313c'U yes
A building permit may be required b i.,,, ,--� 0 P 7 A-ri-1 See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions , Lf , ,..1 or- A- -, —ems, r../ , _--),--, ::- „�.."'7=9C. ,/1-7..+ t"
Agent or Applicant Printed Name Permit Officers Printed Name
, di,14-1 A. ---'-e-c ----7. ----Th
Signature **Please r ad compliance statement on back of permit** Signature
Si Application Fee(s) Check# Issuing Date Expiration Date
1

TOWN OF BATH
BATH, NORTH CAROLINA 950 i DATE /D fi ' 44
•
BOOK NO. . PERMIT FEEYi. PERMIT No.
t
APPLICATION FOIL: BUILDING PERMIT(' ) ZONING COMPLIANCE CERTIFICATE ( )
Name & License No. Address: Phone No.:
OWNER l�J� 01501- .34-744,0
CONTRACTORA-DpiCA S 4-- c .l �P(G�n s 9Vq-F�354
DESIGNER
SURVEYOR
ELECTRICAL
PLUMBING
TYPE OF IMPROVEMENT
NEW (X) ADDITION (' ) ALTERATION: INSIDE ( ) REPAIR: INSIDE ( ) MOVE ( )
OUTSIDE( ) OUTSIDE ( ) LOCATE ( )
Lot No. Block No. Building located at FY S4 1/ e-- P '
between 61* �'\ W0 0 nd Watt,r.fick'D -Theqt+eetsPbtauilding to be used as
. Type Construction Sto:Kil—
Number of off street parking spaces . Contains rooms and bath(s).
Total square feet of building . -ctric Service . Type of heat
. No. of • mbing fixtures . Foundation block caps
4" ( ) 8"( ). Corner bracing: Plywood ( ) othe . Insulation: Floor
Walls , Ceiling . Windows: Storm ( )Thermal ( ). How many exterior doors.
. Water Heater: Gas ( ) lectric ( ) 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 Flood elevation

BUILDING INSPECTION DEPARTMENT COMMENTS:
?14 e_o, Frog. A)srXu..4T1 mF A I3'Al3
8oA-r LJ P ON I ks% c7 4 D O I .X 1 S77N4 P/
"MC Co4. crre0J w/c.t. A-l4/A► BZ'
-h S L.i Fr w►cc eZZeirre I SNP TdrTL, A7 S .
GENERAL COMMENTS: iP Q-/dcI , J drawiij
CITY LICENSE NUMBER:
Contractor/ C Electrician Plumber/Heating
Application approved by: /B ZS-19
The owner of this building and the undersigned agree to conform to all applicable laws of the Town of
Bath, North Carolina.
g•
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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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Su Q NB 7t:- ...b 7) f
I (Name of Property Owner)
property located at / V 7 4.5-h 0'C/ ,r''r,v
(Address, Lot, Block, Road, etc.)
on gQCik CY4..,4 , in 89,4-/-1 , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locations
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
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.)
t.--' I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner I f rmation) (Adjacent Property Owner Information)
i___
. Sinature ((jell) ��i r * I.5 ,San m �lt d I a,,d
Print or Type Na e Prinr r T e Name
c%D3 i J-. -C+ 1a7 kowc. DY►Ye..
IN lin Address tli ddr s
lAis 1�Address, Alt 9 to 0orth ) c . ,7(3968
Ci State/Ziph '�( l r �i y4/Statelui174. c I
A �l l a.
elephone umber/email address Telephone Number/email address
�1L/ l& /6 )1-I1
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ,$ J4ij 8, hW'k U 's
property located at
1 6 7 5`j d�"�i �y,ye./
Property wrier)
(Address, Lot, Block, Road, etc.)
on ficX C'-e , in 134,44 , N.C.
(Waterbody) (City/Town and/or County)
The appli t has described to me, as shown below, the development proposed at the above
locatio r
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
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 w.sh to waive the setback, you must initial the appropriate blank below.)
I dowish to waive the 15' setback requirement.
q
I
do not wish to waive the 15' setback requirement.
j %iJvU
erty Owner Inf rm n) (Adjacent Prope y Ow Information)
�ture ` ' ) L
Signaturg*� �e-20��sari � G✓i°�b /�Ol ���`ic
P ' or Type Nam ,, 1,� Print or Type Name 03 iq L4 i-.&`( t /0 5- s hba-F b-
ili g Address Maid ,s /
� 5. 0-1.i& City/State/Zi .'i City/State/Zip f _ %f tO
Te Done Number/email address Telephone Numb /em I address
4? 4 I Cl c7 j� �d 1 9ate Date*
!!!
(Revised Aug. 2014)
*Valid for one calendar year after signature*

•
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: .Sa h �, ,111,
Mailing Address: 6p 03`i- / 4.41 C
j/ ISO n N (4 a789‘
1
Phone Number: ;cc -�3`76(0 5-- t?7
Email Address: YitVaPPAU qha I. Co rn
I certify that I have authorized bt _ 46 ,0 knS
Ac, nt/Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: B a ' Li f t
at my property located at /O7 5 A to Pri yt, 0A- A/C 2 7 Og
in?-p_thtz- oy County.
I 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:
vir -wt) /1/P/P—
Signature
tJe4b
Print or Type Name
p r%J h -
Title
It I2S I ) l
Date
This certification is valid through I I

Authorized Agent Consent Agreement
1 (.5-0, 0` if , hereby authorize X)51 _,4. p
15? ti t/I A ti rtil.5 to act on
(Property Owner) (Authorized Agent)
my behalf in obtaining CAMA permits for the location listed below. This agency
authorization is limited to the specific activities described above.
Property Address:
/07 Shx)rt. ciVoci
1t--i'k1r ( 2,7101
Property Owner's Mailing Address and Phone Number:
'b $ a0'l /1- 1JQ/Ib
6.))3 V--1(C o a, ,1-,� 6)15
Property Owner's Signature- P'J-70v1/4-1
Authorized Agent Signature:
Date:/6 7s/ q
Form: Authorized Agent Agreement as developed by NCDCM revised 7/29/09

,,. .,
SECTION.1200—GENERAL PERMIT FOR CONSTRUCTION OF PIERS AND DOCKING FACILITIES: IN
ESTUARINE AND PUBLIC TRUST WATERS AND OCEAN HAZARD AREAS
15A NCAC 07H.1201 PURPOSE
A permit under this Section shall allow the construction of new piers and docking facilities(including pile supported or
floating)in the estuarine and public trust waters AECs and construction of new piers and docks within coastal wetlands
AECs according to the authority provided in Subchapter 07J .1100 and according to the Rules in this Section. This
permit shall not apply to oceanfront shorelines or to waters and shorelines adjacent to the Ocean Hazard AEC with the
exception of those shorelines that feature characteristics of the Estuarine Shoreline AEC. Such features include the
presence of wetland vegetation,lower wave energy,and lower erosion rates than the adjacent Ocean Erodible Area.
History Note: Authority G.S. 113A-107(a); 113A-107(b); 113A-113(b); 113A-118.1; 113A-124;
Eff. March 1, 1984;
Amended Eff.July 1, 2009;April 1, 2003.
15A NCAC 07H.1202 APPROVAL PROCEDURES
(a) An applicant for a General Permit under this Subchapter shall contact the Division of Coastal Management and
request approval for development. The applicant shall provide information on site location, dimensions of the project
area,and his name and address.
(b) The applicant shall provide:
(1) confirmation that a written statement has been obtained signed by the adjacent riparian property
owners indicating that they have no objections to the proposed work;or
(2) confirmation that the adjacent riparian property owners have been notified by certified mail of the
proposed work. The notice shall instruct adjacent property owners to provide any comments on the
proposed development in writing for consideration by permitting officials to the Division of Coastal
Management within 10 days of receipt of the notice,and,indicate that no response will be interpreted
as no objection. DCM staff shall review all comments and determine,based on their relevance to the
potential impacts of the proposed project,if the proposed project can be approved by a General Permit.
If DCM staff finds that the comments are worthy of more in-depth review,DCM shall notify the
applicant that he must submit an application for a major development permit.
(c) No work shall begin until an on-site meeting is held with the applicant and a Division of Coastal Management
representative to review the proposed development. Written authorization to proceed with the proposed development
shall be issued if the Division representative finds that the application meets all the requirements of this Subchapter.
Construction shall be completed within 120 days of the issuance of the general authorization or the authorization shall
expire and it shall be necessary to re-examine the proposed development to determine if the general authorization may be
reissued.
(d) Any modification or addition to the authorized project shall require prior approval from the Division of Coastal
Management.
History Note: Authority G.S. 113A-107(a); 113A-107(b); 113A-113(b); 113A-118.1; 113A-124;
Eff. March 1, 1984;
Amended Eff October 1, 2007;August 1, 1998;January 1, 1990.
15A NCAC 07H.1203 PERMiT FEE
The applicant shall pay a permit fee of two hundred dollars ($200.00) by check or money order payable to the
Department.
History Note: Authority G.S. 113A-107; 113A-113(b); 113A-118.1; 113A-119; 113-119.1; 113A-124;
Eff. March 1, 1984;
Amended Eff. September 1, 2006;August 1, 2000;March 1, 1991..
15A NCAC 07H.1204 GENERAL CONDITIONS
(a) Piers and docking facilities authorized by the general permit set forth in this Section shall be for the exclusive use of
the land owner, or occupant and shall not be leased, rented, or used for any commercial purpose. Piers and docking
facilities shall provide docking space for no more than two boats. Docking facilities providing docking_space for more
than two boats shall be reviewed through the major permitting process because of their greater potential for adverse
impacts and,therefore,are not authorized by this general permit,excluding the exceptions_described in Rule.1205 of this
Section.
(b)Individuals shall allow representatives of the Department of Environment and Natural Resources to make inspections
at any time deemed necessary in order to be sure that the activity being performed under the authority of the general
permit set forth in this Section is in accordance with the terms and conditions prescribed herein.

(p) Piers and docking facilities shall in no case extend more than 1/4 the width of a natural water body,human-made
canal or basin. Measurements to determine widths of the water body,human-made canals,or basins shall be made from
the waterward edge of any coastal wetland vegetation which borders the water body.The 1/4 length limitation shall not
apply when the proposed pier and docking facility is located between longer structures within 200 feet of the applicant's
property. However,the proposed pier and docking facility shall not be longer than the pier head line established by the
adjacent piers and docking facilities nor longer than 1/3 the width of the water body.
(q) Piers and docking facilities shall not interfere with the access to any riparian property, and shall have a minimum
setback of 15 feet between any part of the pier and docking facility and the adjacent property lines extended into the
water at the points that they intersect the shoreline. The minimum setbacks provided in this Paragraph may be waived by
the written agreement of the adjacent riparian owner(s),or when two adjoining riparian owners are co-applicants.Should
the adjacent property be sold before construction of the pier commences,the applicant shall obtain a written agreement
with the new owner waiving the minimum setback and submit it to the Division of Coastal Management prior to
initiating any development of the pier or docking facility. The line of division of areas of riparian access shall be
established by drawing a line along the channel or deep water in front of the property,then drawing a line perpendicular
to the line of the channel so that it intersects with the shore at the point the upland property line meets the water's edge.
Application of this Rule may be aided by reference to the approved diagram in Paragraph(t)of this Rule illustrating the
rule as applied to various shoreline configurations. Copies of the diagram may be obtained from the Division of Coastal
Management website at_http://www.nccoastalmanagement.net.When shoreline configuration is such that a perpendicular
alignment cannot be achieved,the pier or docking facility shall be aligned to meet the intent of this Rule to the maximum
extent practicable.
(r) Piers and docking facilities shall provide docking space for no more than two boats(a boat is defined in 15A NCAC
07M.0602(a)as a vessel or watercraft of any size or type specifically designed to be self-propelled,whether by engine,
sail,oar, paddle or other means,which is used to travel from place to place by water) except when stored on a platform
that has already been accounted for within the shading impacts condition of this general permit. Boats stored on floating
or fixed platforms shall not count as docking spaces.
(s) Applicants for authorization to construct a pier or docking facility shall provide notice of the permit application to
the owner of any part of a shellfish franchise or lease over which the proposed pier or docking facility would extend.
The applicant shall allow the lease holder the opportunity to mark a navigation route from the pier to the edge of the
lease.

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant Sm 5 A nl W
Date: 2.e6 4-, oftx._ Z 1
General Permit#: —? q. '1 —3
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. ' ANAL Sq. Ft. ', TOTAL Feet FINAL Feet
(Applied for. (Anticipatednnal (Applied for. (Anticipated final
DISTURB TYPE Disturbance total disturbance. Disturbance disturbance.
Habitat Name includes any Excludes any total includes Excludes any
Choose One
anticipated restoration any anticipated restoration and/or
restoration or and/or temp restoration or temp impact
temp impacts) impact amount) temp impacts) amount)
Dredge❑ Fill❑ Both ❑ Other ND �( � 'FT `bc-t
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 ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
I � I
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
' I
Dredge❑ Fill❑ Both ❑ Other ❑