75407_Jason Pair_20200113

•> CAMA
/ DREDGE & FILL ZD# (05000 �5 No. 75407 A C D
GENERAL PERMIT Previous permit# N )A
h-d' ew JModification _:Complete Reissue JPartial Reissue Date previous permit issued r.j /4-
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 7--'`-/ ' '--.°v O"t' ' l40 a .
,. kules attached.
Applicant Name --4 A So })A I Project Location: County "IBC 4,-,Z c. -c ,�
Address 15.2- G NT r! , ( pc7 1,. T Street Address/State Road/Lot#(s)D r s- r' , - , ,
City j.A-+- k..I State NI (' ZIP Z')43 -_ / S2 A,,' . p p' ,.i T-
L
Phone# t .)4/3 . .1 ;/-2 E-Mail Subdivision G-Qi ,1 ' P +-?=-",•- ' -r- -
Authorized Agent i/14 City 1-z i--I ZIP -) `z?e
Affected O cw L EW )PTA '-ES ❑PTS Phone# ( ) River Basin I fa Q- -PA vi )� _
El
AEC(s): OEA J HHF L IH UBA ❑N/A Adj.Wtr. Body ) `1.77! '-v-,_"E - , (hat man /unkn)
❑PWS: _
ORW: yes / no PNA yes / no
Closest Maj.Wtr. Body ' .�n� '`•� 7'-' �-
Type of Project/Activity i rtiz „, ,- <'1 , ' 'i,7. Fri • A_l f .--.)../.--,
/- (Scale: I : 3 Gt )
Pier(dock)length-- :_, .. .
1
Fixed Platform(s) =2 x t�5 ogles "� + '
Floating Platform(s) ; I f it /
Finger pier(s) t.; - , t `1 `
Groin length o v 5 �/ . . r-1 /� /^
number l -2-2.. v f - S 1 -- Glriy�0-k, .
Bulkhead/Riprap length ' L- Q C? 1 ' r / 1yc.,. � rZ .
avg distance offshore
/J/. j
max distance offshore ( i -
Basin,channel bi lrJ0 t
Rkk
'cubic yards • I I '—'
Boat ramp x y,s-i o--)y --.f Go KJ 7•4t u r '2.. ;.� i e..
Boathouse/Boatlift - P. A.,.c• L ,c'T r - (7 4::+'
Beach Bulldozing ' i kr" 6 QO'NJ
Other h
\ •
w
E- -zu it
_ _ 14 __- 1
11,
Shoreline Length /i D Ail�,' �" S� TT-4
V �_ �' o ac_ )
,,
SAV: not sure yes no)— ___.__..—_.._. _ -
'
Moratorium: n/a yes , �no ,L' I � �7
Photos: yes I1O i _.. f__ _ i ` j �� _.
Waiver Attached: yes , ' I 1
A building permit may be required by: !Z> u.o f-) c7? 1-1 See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions --- D T -1-7\ -��,,--1-r t__I en ( c NA,Oc., --►-c >t /4--/-l2 ---✓� -
,11/ \-rl T ''(y 4-.) -_", ti-, io -F ' L. ,7, -!-1 5=c�.1�. ,,--yt t , ., ..-.�` Aci I_o LAB :.�
`4 O D -v S -i - D---2A i / c iN,2_.- (41-V) C•<-.:f c-)'7 4 O --,.'', .,.:
��/i it
�c �. .' � tJ mac---J
Agent or ••• Printed Name Pe 'tOfficer`s Printed Name
Signature Please read compliance statement on back of permit** Sig)iature-) \
N
' Application Fee(s) Check# -Isfuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief,certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar-Pamlico River Basin Buffer Rules Other:
n Neuse River Basin Buffer Rules
If indicated on front of permit,your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-648 I) or the
Wilmington Regional Office(9 I 0-796-7215)for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves:Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 9 I 0-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare,Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

TOWN OF BATH
BATH, NORTH CAROLINA DATE 1/
BOOK NO. PERMIT FEE PERMIT No.
APPLICATION FOR: BUILDING PERMIT( ZONING COMPLIANCE CERTIFICATE ( ,�J
Name & License No. Address: Phone No.:
OWNER v u -. P..,_ n
/3,./),(VC- . s 2
CONTRACTOR 1 L 17 'I1c� j< 2 ?pa
DESIGNER
SURVEYOR
ELECTRICAL
PLUMBING
TYPE OF IMPROVEMENT
NEW ( ) ADDITION ( ) ALTERATION: INSIDE ( ) REPAIR: INSIDE ( � )� MOVE ( )
OUTSIDE( ) OUTSIDE ('LOCATE ( )
Lot No. Block No. Building located at 5- < J3J4 w�
between and Streets. Building to be used as
Type Construction
Number of off street parking spaces . Contains rooms and
bath(s).
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 manyexterior 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,E
Other . Zone . Water and Sewer Tap: Paid ( ) N/A
( ) Size water tap
Size sewer tap: .Total Estimated Cost Flood elevation

i
BUILDING INSPECTION DEPARTMENT COMMENTS:
t 44 E 14b `r7 G iv,Gwn '
�LL 1.1 � to mu
..� �. 6x�s nub p_ t 4 /o
rt.-
GENERAL COMMENTS; 6-< L{ ��
�.J rt`-� cti" el, !
I - ,x-f•-)" we-.I 0.--1 cic�4. L.) -I/ ,r tea. n II
r-.)-r.it
rr� R GI" �� ri�``t r I
K ___.g
-mow
CITY LICENSE NUMBER: ,
Contractor/AC Electrician .5
Plumber/Heating
d
Application approved by: — / �g 2/2
The owner of this building a the undersigned agree to conform to all applicable laws of the
Bath,.North olin , Town of
,, \r
Signatur of plicant
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.
Ps.
Bath Utilities Department must inspect all construction prior to services becoming operational. Inspection
fee is $100.00.
i.
Teoiciasa•
f1f
r �° 6
E�S��
1 tJnl 0

Authorized Agent Consent Agreement
I, ,herby authorize Tobin Jay Tetterton of
(Property Owner(s))
TJ's Marine Construction,LLC to act .,n my behalf in obtaining CAMA permits for
the location listed below.
PROPERTY ADDRESS:
PROPERTY OWNER'S MAILING ADDRESS:
Phone No. c252 - L/I 3.- `3 5
PROPERTY OWNER'S SIGNATURE: ; '4?
AUTHORIZED AGENT SIGNATURE:
TOBIN TETTERTON
DATE: // ' /5 20 /
W/Authorized Agent Consent Agree.

ADJACENT RIPARIAN PROPERTY OWNER S"ATEMENT
I hereby certify that I own property adjacent to ^'u--
property located at / 54 ic P (Name of Property Owner)c� .,•
• on - e„fi., C r , (Address, Lot, l loc Rpad,etc.)
(Waterbody) , in �''►►�� , N.C.
(Cieyfrown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location/
Adjacent V I have no objection to this proposal.
Property
Ocrimer
Medene i have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or mach a site drawing)
net,1/Y Cv-(r'e-,+ 1,ere' u� r�e�.� L,�o Nei , C' 'I,' s
li2-tce P;a "} • 5.
•
A-VV4J r.44 /9' 71 " i 1
A l)- T U (U`h C„,✓►�Y,+�, d G �" S b c /
�.�., �� L WAR SECTION /'��S ,z/� Q
-)
. .
b I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, li>'t, or groin
;vim. must be set back a minimum distance of 15'from my area of riparian access unless waived by
.:' me. fiyou wish to waive the setback, you u initial the appropriate blank below.)
v�8
/ if do wish to waive the 15'setback requirement.
I do not.wish to waive the 15'setback requirement.
(PropeIty Owner Isdor � n) (Adjacent Property Owner Info aun)
1::: ____- /‹
Sid Signa re
Print or 7-me Name Print or Type anie( L .71
c..b,-,r Pit / p p
Mailing Addse s mailing q
11 ` ��b'��9 g r5ad
<rtrE, ctJc •) -7 i0(;)
City/S'tate2ip Cfty/State/7ip
s,- 44 ,sr -)
y
Telephone Number/email address Telephone Number/email address
/1 - /5- /g // - , s- 15
Dane .
Date*
(Revised Aug.2014)
Valid for one calendar year after signature=

0
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that i own property adjacent to 3,,-. Pe.-.r e_ S�t.^ <<r,.r LJ(
(Name of Property Owner)
property located at / CC_ ( Pi-
on U -11, C,-v_„Q. (Address, Lot,Block,, ad,etc.)
, N.C,
(Waterbody)
(+Idatyt'8'"owra arad/c+r County)
The applica t has described to me, as shown below, the development proposed at the above
location.
I nt i have no objection to this proposal.
property
owner
one
check I have objections to this proposal.
DESCRIPTION AND/OR DRAWINO OF PROPOSED DEVELOPMENT
(Individual proposing ng development must fill In description below or attach a site drawing)
r��(�K �,.,� �..f L, � •. c � r .r.j j . c -
as 's.
G
s, ..?4 lis-)
z.
amst WAIVER SECTION U
Property I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathous' li>t, or groin
must be set back a minimum distance of 15'from my area of riparian access unless waived by
me.elf -u wish to waive the setback, you map inifai the appropriate blank below. ge1/4
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
(P:'ope21y I tio ) (Adjacent Property es,Informetlon)
, d r
Sign e
`}n P....: Signatu-reM .
Print or Type Name Print or Type Name"
Mailing Address h /5L) <<.d . ( P 11
i3.h, / '-7y 9 MailingAddress sL
`' ��lam. c �-,"co
City/State/Zip City/State/Zip
2)2 - if, " `'s'7 )- - `��4 � 1 -
Telephone Number/email address Telephone Number/email address
// - i ( i5 //- / C- /S
Date - Date-
(Revised Aug.2094)
'Valid for one calendar year after signature° .

NC Division of Coastal Mgt, Habitat Impact Computer Sheet
Applicant:
Date: - -* -'-c 2.C/2_o
General Permit#:
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 FINAL Sq. Ft. TOTAL Feet FINAL Feet .
(Applied for. (Anticipatedfinal (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)
DrtrN
Dredge El Fill El Both El Other 1 �cep 7-. -)9v
Dredge El Fill El Both ❑ Other El
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
•
Dredge❑ Fill❑ Both ❑ Other ❑
• Dredge❑ Fill❑ Both ❑ Other Cl
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill El Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other El
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both El Other ❑
• Dredge❑ Fill❑ Both ❑ Other ❑