79105_Donal & Sharon Rose_20210407

� M CAA/ ❑DREDGE & FILL ��l "'�1S
N 9 79105 A lta C D
GENERAL PERMIT Previous permit# 14/6
Yam'' Mew ❑Modification LIComplete Reissue ❑Partial Reissue Date previous permit issued Niii
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 ISA NCAC Q - vZc)a ,
`, . 1 es
Applicant Name ono '6slaro'—SC. — Project Location: County K er — -
P.Address f.0. F:Znt, Ig 35 Street Address/State Road/Lot#(s)
City C4R.43 State MC— ZIP o?1St" 12S3 %eceh S 7014* Pa
Phone#(f4) 425 -o49# E-Mail Subdivision j /Pi
Authorized Agent'7 -3a5 rAc i4 e- Cool Sty. City g AT Ir ZIP aT$C343
Affected ❑CW o EW )(PTA ❑ES OPTS Phone# (4)q )613'05d.3 River Basin TAR/'PAM
s: 0 OEA 0 HHF 0 IH 0 URA ❑N/A
AEC(s):
g/�}
❑PWS: T1�
Adj.Wtr.Body _ougeK Y'
(f man lunkn)
ORW: yes / p� PNA Q/ no �.nke,t 1 Closest Maj.Wtr.Body_'A/r(✓I iI g C' v t _
Type of Project/Activity. 15) 5l1 /3 "x 13' ba4 f11 T7 d" C t l a Af, 97AVt'
04 DrIf
ensTier (Scale: 1�� -36' )
Pier(ddk)I
Fixed Platforms) ^4 0#/-04 C -F- I ` -_--' l .. . _ . _ ... t
Floating Platform(s) .
1
___.. .... . 4. ___;,,Ir Clik,,k. -4-: -Finger piers) �rita t`7
Groin length i . !Y1 i I �_ l _ ;
number ; - ' I '. 1 i —'� . i i j T, - I
f
i _
Bulkhead/Riprap length -}_ -j-.�_ i. . i . 1 I�r It t 5
avg distance offshore `---` - ► 4 ns �
max distance offshore - ._ . -
' 4" jc 11, '
Basin,channel .
cubic yards ` l.� -.Jr
x
• 1"`
Boat ramp _
--�- --.- -__ --remu '
Boathouse/ oatt 3 A 1�3' -- . - . I. 1 • : . • : • '-- i
W.:
;I.:).
ttBeach Bulldozing i } i ( j ( 'Other _--- _
Shoreline Length I- /3 6'# L- :_ r :_: XW L Kam' _ --1 i :--- -
,- e
SAV: not sure yes () ' _--i-_
Moratorium: a yes ®� • W 1 " , �Z si-,...5 s ir,
Photos: yes no . - - 1�. ` . , r�WT.'. : 1 i i .
WalverAttached: e0 no I. ..__-- - . . I -._ s_-- ----: --
4 j_DWI+ .- 'g 4-T1'} --
A building permit may 6e required by: 0 [V See note on back regarding River Basin rules.
(Note Local Planning jurisdiction t R n
Notes/Speci Conditions l 5 1(1<IAI kWh() W 4(Q )u Tree,, -T t4 a
'11 Alf u Qf414e). o`' tv,(I have 2 or- 4--ke Qllo4
Z bccAsi►75 -
Cr -1-a.I TT-1-;er-f ov 4-4) 6ret
Agent or Ap rin Name :!rez %_
's Printed
f of gal ri 1 -per,;! - 2 1) - 7 - usf-2021
Application Fee(s) Check# Issuing Date gxpiration Date

ROY COOPER
„a Governor
MICHAEL S. REGAN
.. Secretary
Coastal Management BRAXTON DAVIS
ENVIRONMENTAL QUALITY Director
-
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
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.
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 roject site conditions: tort J( Alai." i1-ce
- 41011.• w% aL
By your signature below you agree to be held responsible for meeting all of the conditions listed above a verif Y
that all informa . n provided is complete and accurate.
C T-2--�-f07 f core
Agent Ap icant Printed Name Permit Offi is Si nature
Agent or Applicant Signature Issue Date
CAMA GENERAL PERMIT#: r/t0 S 5
State of North Carolina I Environmental Quality I Coastal Management
Washington Office 1943 Washington Square Malt Washington.NC 27889I 252-Q4(s-6481
Wilmington Office 1127 Cardinal Prive Ext.Wilmington,NC 28405-38451 910-796-7215
Morehead City Office 1400 Commerce Avenue Morehead City.NC 28557 1252-808-2608

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to D o r a id 1- SI-1 a roil ik o.se 'S
(Name of Property Owner)
property located at i,253 reach's Poi of Roati
(Address, Lot, Block, Road, etc.)
on 8oci-h Creek , in 13ci th , N.C.
(Waterbody) (City/Town and/or County)
---- - The applicant has described to me, as shown below, the development proposed at the above
locati)26.
Adjacent. V I have no objection to this proposal. 6concrer-o aN 4l/6 y"g Pam" ern//)
P:G¢2i Y5, 4i d.) NA.
Griner I have objections to this proposal.
Check;one
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposinv development must fill in description belot,v or attach a site drawing)
E___ _ _i , 0
o
fa'
i
20 0 boa f
r
n
r
i WAIVER SECTION
iON
°i�`�"= I understand that apier, dock, mooringboat breakwater, boathouse, lift, or groin
Property ram P,
se> must be set back a minimum distance of 15' from my area of riparian access unless waived by
"'' •u wish to waive the setback, you gust initial the appropriate blank below.)
!:air W i,y J ---
- /�i I do wish to waive the 15'setback requirement.
i do not wish to waive the 15'setback requirement.
(Prrgperty Owne Information) (Adjacent P rty Owner info tion
Signature y }i Lzs
Donald, + Sh4ran R:7s� g ',.. /ttk,grle-,/ �.f/..he.
Print or Type Name Print or Type N_ye /pe J
P, 0. lax 63S /.Yv_3 /✓ / cL5 — J
Mailing Address Ma Address
&Arner / tx/C. A7S 9 &Og
big)
g)City/State/Zip t ` _ j 9 �9�
t19)oA3-039y (914�1e23-0513
-telephone Number/email a dress Telephone Number/em it addressf
0te! 3J aOR.) „ � or /
Date Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature"

r
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to D o r i Id 1- .S ti a ro n R O S. 7s
(Name of Property Owner)
property located at M 53 read-)-s Po i riT IZ 0nii
(Address, Lot, Block, Road, etc.)
on 8c,1-h 'rezk , in Sol t-h , N.C.
(Waterbody) (City/Town and/or County)
- The applicant has described to me, as shown below, the development proposed at the above
location.
Adjacent (-4'— I have no objection to this proposal.
Property
Owner I have objections to this proposal.
Check one
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
o
it '
200 i j7e41-
.
Adjacent 1 WAIVER SECTION
Property I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
Cwner must be set back a minimum distance of 15' from my area of riparian access unless waived by
'tusi u to waive the setback, you must initial the appropriate blank below.)
o wish to waive the 15' setback requirement.
i do not wish to waive the 15' setback requirement.
(Prgperty Owne Information) (Ad- nt Property Owner Infor
tt9an C, k e_ a
Signature v Signatt6rm-
bonaIa -I- Sht,ren Re se. ck t clIKK0 1 ftL ADRi�Print or Type Name not orype Name
P, O. 6ex 63S 3-3DI' t,t)ALT=N DA,
Mailing Address Mai/l'Rg Address GGrner , 1\1G A 7.7 a 9 (-- -te.F k'iu v v�`/
(�. A.) • � ° .,t 7 6S
City/State/Zip City/State/Zip 1
�1i9)b;3-03gy (9Iq)6.23-1JSi.3 ,2$.2— 7c�0'- /2i 7
Telephone Number/email address Telepho e Number/email address
Date/
aO J A .z3i 2.,z /
Date*
(Revised Aug. 2014)
Valid for one calendar year after signature*

PROPERTY ADDRESS:
Donald 4- 5kAron Rose.,
/? 3 Teacl,'s Pot.,4 Road
NC- a7.90
PROPERTY OWNER'S MAILING ADDRESS:
Donaiol e+- S IcSe
P, ©, Box (o35
Ga -nerI NC-
Phone No. (') 19) to a3 039 MN)(0.Z3-0-C63
/0d->i GO. fio.44—,
PROPERTY OWNER'S SIGNATURE: s.2 Xe,1l e,-i .
AUTHORIZED AGENT SIGNATURE;
T BIN TETTERTON
DATE: 03! a 3 20 i
W/Authorizcd Agent Conscnt Agrce.

TOWN OF BATH
BATH, NORTH CAROLINA
DATE ""-", 2
BOOK NO. PERMIT FEE
_____PERMIT PERMIT No,
APPLICATION FOR: BUILDING PERMIT(
ZONING COMPLIANCE CERTIFICATE ( ✓)
Name & License No. Address:
OWNER �°d �,err /Cn4- a 83 Tea eji s /�o:n t— Phone No.:
CONTRACTOR / US ►''i�1L° �C ak /� — 9/(c -6 ?3&39`f
DESIGNER G2� Nc lit77
SURVEYOR
ELECTRICAL
PLUMBING
TYPE OF IMPROVEMENT
NEW ( ADDITION ( ) ALTERATION: INSIDE
( ) REPAIR: INSIDE ( ) MOVE ( )
OUTSIDE( ) OUTSIDE
( ) LOCATE ( )
Lot No. Block No.
Building located at
between
and
— ___ Streets. Building to be used as
Type Construction Q7� ,
Number of off street parking spaces
Contains rooms and
Total square feet of building bath(s).
Electric service
. Type of heat
-- • No, of plumbing fixtures
4,.( ) g�.( ). Corner bracing: p1 • Foundation block caps
Plywood ( )other _
—_______ Insulation; Floor__
Walls C211inA
Windows: Storm ( )Thermal ( ). How many exterior doors Water Heater: Gas ( ) Electric ( ) Other
Roof Ventilation: Gable ( ) Eaves ( ) Louvers ( ) Other
crawl space, number of feet apart Ventilation
. 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:
aA r l o�ri4 r
.�� s rUG r Lr s
0A) SL/p iL/�
/Ai �wru6
f "7 w,4 0E- AM(
o.vrN,G
G ERAL COMMENTS. • 1 -
,e, it_ A 4 e ' :I illananirF ic ________
CITY LICENSE NUMBER:_
tUti_____
Contractor/AC
-----Oectrician --
Plumber/Heating
----
Application approved by:.
-Z
The owner of this building and the undersigned agree to conform to all applicable
Pp ble laws of the Town of
Bath, orth Carolina —
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
A) Be installed by owners, contactors or may:
B) Be installed by Town of Bath Utilities Department
All components must be compatible with existing water/wastewater materials, including
Bath Utilities Department must inspect Myers pumps.
fee is $100.00. P ail construction prior to services becoming operational. Inspection

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Beaufort County, NC
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20 m Mar/24/2021
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