79704_Walter Polland_20210526

CAMA/ G DREDGE & FILL
GENERAL PERMIT �, "1y704 A ®I C D
Previous permit# t I/tA
Y-- ?Jew 'lModification I-Complete Reissue LiPartial Reissue Date previous permit issued NI/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 I 5A NCAC O 1'h!. 'Zt.bc.tp 4 .
23'Rules attached.
Applicant Name_ ► '_ 11.2 t‘4YY)_ -_ _ Project Location: County 3&L
Address t9D0_ ,YesfAgi. i_..-t•C-._ _ Street Address/State Road/Lot#(s)
City_-_.?eii1_,Jl&. .State ZIP ,P3-13 3 (p tog' cot s 126
Phone#(252)144-S1-Y -* --
E-Mail. _ . ` ""` Subdivision
•
Authorized Agent `s ire\gvor;,,,.,e._ City_— ___-_ ZIP a 41g9s.
rim DEW ps PTA J ES OPTS Phone# x j(
Affected (__....) l "5Z i River Basin--1+p—�- I
AEC S : '00EA i7HHF 7IH LIUSA IN/A
( � Adj.Wtr. Body C�x'�k. nat .,Lunkn)
L I PWS: — man
1)4/1 Closest Maj.Wtr.Body_Pc!.. L& jve,-. _.___
ORW: yes /sw PNA �+
Type of Project/Activity eon rat .4•1 a `>} , t.' rp tr cock ., /2'A Zp'2 r/y7
--.at 1( 1*k C'.a:,r i t5144.1c ►", JO(1 SYl►^5 t4 -A- f\b eArrfiM wd' O al : !' f ^,3o' )Pier(dock)length �' y� 547aedu. - ..>
)
Fixed Platforms)_. Z rA(ZU/ ,,►�(\.. ../�
NIFloating Platform(s) ! `-'` `'rC�C��,. j 1
Fi er 1 ##
Groin length _ (..
number I j - -...._. }
I. I_
Bulkhead/Riprap length .
_I
avg distance offshore v ; ! .
max distance offshore `{-�1 1.1 C.I
Basin,channel —. { /2 C 20 ---� A"rg%t s hoc
7i, ,p., , !
cubic yards •
! i
Boat ramp
Boathouse/Boatlift Corst-4ect. z_._ 1;
(0
Beach Bulldozing. -- 1:;)1. r .'
Other ,
L
f �4
A
Shoreli
ne Length _.. �.. �5 b 1 tr t^ ,
SAV: not sure yes o eta I
Moratorium: n/a yes
no �t*, - �
Photos: �1JfZ L. 1))ttlf" � i
.
Waiver Attached: (Ea no
� I f l
A building permit may be required by: fDivk O SI? .See note on back regarding River Basin les.
(Note Local Planning Jurisdiction)
Notes/Special Conditions TT..,a., a 2ey,' co Q441t..Lc1• o
f l ti CI lAtUt. w , a ,, ♦ree s Con 34-44,,{f9 , c I« d- � 41.�
rirp
f' wi H �rxrc f i11 p+-,:-1 /36 P,li4 F s Ck :
viet Val iank.6.
c t
O 4. A hity Croodv_
fir ph`t anted ame Per it ffic is Printed e
e..i.zol
nat i/ ere com lance statemen on back of permit** Signature
h �t 52a), 505 R(Q-_11 y -DRt - (VP-5e . ( 0611
Application Fee(s) Check# IssuingDate
Expiration Date

.? ROY COOPER
' Governor
MICHAEL S. REGAN
Secretory
Coastal Management BRAXTON DAVIS
Eavinot MO(TA{.QUALITY
UreaOr
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.
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-project site conditions: Got %s / lim
4ow w a IL7� s
By your signature below you agree to be held responsible for meeting all of the conditions listed a ve and verify
loll informatio provided is complete and accurate.
t o Applicant tin ed Name Permit face s Signa
Agen or Applicant Signature /" 4/ ��/ ZOZ
Issue Date
CAMA GENERAL PERMIT#: .3-O/ 3
State of North Carolina I Envcronmmtal Quality i Coastal Management
Washington Office 1943 Washington Square Mall Washington..NC 27889 1252-946-6481
• Wilmington Office 1127 Cardinal Drive Ext Wilmington,NC 28405-3845 i 910-796-72l5
Morehead City Office 1400 Commerce Avenue Morehead City.NC 28557 1252-808-2808

Attthorized Agent Consent Agreement
1, d 7 er f l f1 h
erby authorize Tob Jay Tetterton
( rope ty owutr(s))
J's Marine Construction,LL..,C to apt on y bed in obfnh g CAMA permits fo
the iocca-tion Ustel±be'ow.
PROPERTY ADDRESS:
45 �4� A 4
(70v--1) A) a e
1
PROPERTY OWNER'S MAILING ADDRESS:
/9°6 (i0f,kSA;CC--- ,-D--
� Y.:7°A Lae- A/C /T5
Phone No. A o? 7/ 7 s72/
PROPERTY OWNER'S SIGNATURE:--he;"/
AUTHORIZED AGENT SIGNATURE: 7 (----72
TOBIN 'f"E'1x2 ON
FDA u “ i 7 Zo oA
•
vy- uultos-i7 Aga t ConseIIt Agee.

ADJACENT RiPAR A PROPERT1t OWNER S A EMM
hereby eer: 1 that I own property adjacent to )94,/,pfil of Property Owner)
property located at � �, (./3(19(.0-1.5
Addr low..R d
Materbodyr (cityrrown andior County)
_--— The applicant has described to me, as shown below, the development proposed at the abavg
14tiorl.
£5 s i nave no objection to this proposal_
have objections to this proposal_
OeSOREPTION AND_!OF DRAINING OF PROPOSED DEVELOPIiIEN'r
(indi uIc uai proposing development must fill in description below or mach a site drawing)
ear/ !719, ie�'
doiks/fad-7-0,::), o -(1 /2htsd /qL)c
- IWAlVER SECTION
,;,:__. I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
- � must be set back a minimum disi nce of 15'from my area of riparian amass unless waived by
me. (If you wish to waive the setback,you must initial the appropriate blank below.)
I do wish to waive the 15'sethack requirement
i do not wish to waive the 15'setback requirement
Trop y_ es xrsa n) (Adjacent Property Owner Information)
S.
111 i 4& Th o 7. F1,o vn% 1"-S�1
or T Name
rr r 1 ye am Print Type N
yo
4Ring Address Mailing Address
�/1f�— i3 7147 r 27.922
/7 '721 CayiStateefi 3— 3`# `T S
Telephone Number/email addrr?cc Telephone Number emailaddress
-7 ff 1E— �,v2-1
Dare -
DCltC
(Revised Aug.2014)
*Valid for one calendar year-after signature*

ADJACENT RIPARIAN PROPER OWNER STATEMENT
/
hereby certify that E own property adjacent to 6 Q s ( 7 's
drop located at
gie5 �(1)L3Al s / of Property Owner)
i (Address o bopRo d, )on ''\Li el(ik- ate e/t. ,in 4/'ii -y
(Waterbody) (City/Town and/or County)
__—.— The applicant has described to me, as shown below, the development proposed at the above
io�?
ate , t .i.„ I have no objection to this proposal.
er 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)
(� rn D e �577� / e/"' /i/a14
{� 5 /%
?c % j sir
ric is/2--.fier...-s---1,60 ,--
UPS /1 Uj°1/<--
WAIVER SECTION
OValt
erq I understand that apier, dock, mooringlift,pilings, boat ramp, breaKwatex, boathouse, or groin
�N must be set back a minimum distance of'15`from my area of riparian acr '.s unless waived by
74 me. (If you with to waive the setback,you must initial the appropriate blank below.)
c
Ffi ' I clo wish to waive the 15'setback requirement.
u
do not wish to waive the 15'setback requirement.
(Property Owner. forma-on) / (Acracent Property Owner Information)
krif rer—cif ,4`,‘; P /
r,z,:eA,1?l/--F------ 19-7e----
le-d (1,D 4-
74TIPANtam./04;er. -- - Pgr 14irNam4e,".._. •
=A2lire/;-9--
g�}ddtess
A-in
C -2 7/7-'.57 % C e' Ise
Telephone Number/email address Trepae Number!email address
.Jute - Daze*
f- )-11-6d-f
(Revised Aug.2014)
`Valid for one calendar year after signature*

TOWN OF BATH
BATIK, NORTH CAROL!NA
BOOK NO._ PERMIT FEE
PERMIT No.
APPLICATION FOR: BUILDING PERMIT( ) zoNING COMPLIAN
CE CERTIFICATE ( )
Dame & License No. Address:
OWNER �_ ‘S ,-acts ,�'� Phone No.:
CONTRACTOR .% ILC' ©x /7s
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 C�
between and
Streets. Building to be used as
Type constructio Le
Number of off street parking spaces
Contains rooms and
Total square feet of building bath(s).
Electric Service
Type of heat
. No.No. of plumbing fixtures
. Foundation block Cdp5
4"( ) 8"( ). Corner bracing: Plywood ( )other_
Z�suiauvn, r`ioor
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"
zone ( )
Water and Sewer Tap: Paid ( ) N/A ( ) Site water tap
Size sewer tap: Total Estimated Cost
Flood elevation

BUILDING INSPECTION DEPARTMENT COMMENTS:
NERAL COMMENTS:
Itll E' • c Q ' i7 4%4 !.r/'/yt
CITY LICENSE NUMBER:
Contractor C
Electrician Plumber/Heating
Application approved by:
Diu/ �l S 3
The owner of this building and the a undersigned agree to conform to all app
licable cable laws of the Town of
Bath North Carolina,
Signature of A plicant
Effective 8/10/04, there is a $50.00 riling fee for all permits, including
Any construction that requires installation of water or wastewater services Zoning compliance application.
A) Be installed by owners, contactors or ►vices may:
B) Be installed by Town of Bath Utilities Department
All components must be compatible with existing water/wastewater materials
Beth Utilities Department including Myers pumps•
fee is $100. must inspect ail construction prior to services becoming operational. Inspection

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Beaufort County, NC GPIN:6653-64-2279 LAND VAL:46500 DATE:1/1/1900
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ii
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