79877_John Hauser_20211001

•
dAMA/,❑DREDGE & FILL1 -il
lr9 77077°'
C�f C D
GENERAL PERMIT '14 �0� ermit#
►aA
p /
CNN ew ❑Moclif Previous cation ❑Complete Reissue ❑Partial Reissue Date previous permit issued N / r
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 I5A NCAC /./•_ l&D
Rules attached. ,
Applicant Name -3-.0 1 V1 41 use r' . Project Location: County ac.,-rt,/i- ,
Address 1 (, _ is,r n Y3 cA (b(er-"\ Street Address/State Road/Lot#(s)_
City 75c-Mr) State N(..... ZIPo),'7-R03 )Z,t) vi,111.i00;e4 (2cx..A
Phone#(` K ) (Qr()-SUP; E-Mail Subdivision )3, l'f)cio G- 4 e !' )V n �kL
Authorized Agent '7'--5-` 5 ma.te- r (E)115 k. City )A T 1\ ZIP X-4'SOS
Affected ❑CW CI7I EW RPTA ❑ES ❑PTS Phone# ( ) River Basin g/FAPl-,
AEC(s): ElOEA CIHHF ❑IN ❑UBA El Adj.Wtr. Body T/F C66e k ,(na f man /unkn)
❑PWS:
j '\ Closest Maj.Wtr. Body 7��/t t /Iaf U e
' ORW: yes% .no PNA es /}no iy9 j) / gel Ileac)
/
Type of Project/Activity ?:116Tca)1 L'X )3y t �i-e r c=►,7.4 gel Su ( I / Z. - Il eac) r /a 7g'.-vo~
a X l r • 1-)c,.'k UR-A (Scale: j t'. p" )
Pier(dock)length to e i I SLIT .qt •
Fixed Platform(s) AI x 1 ` l4 2- 1-q-+. J t. ! ii‘i , .� f
Floating Platform(s) �— 21; X�;I.l! �'h �� i j! I i
Groin length —__._. ` , �l" 1 — —* ` :'4 , - 1... .-.�
Finger pier(s)
��.. i" i I: Ail
i
number .ar �� 1—I — - — 1-- -- . _..— 1
Bulkhead/Riprap length I— _ -._.__-_ , �-_ ,-._........_� --) ........._i I {---
ck _
,avg distance offshore 1 1 I • i 1 -
max distance offshore ; i. '1 _ Ti
Basin,channel d �" d€. t �I' 11"
cubic yards •
•
>, Il
Boat ramp i. . . I ��� I I
Boathouse/boa t rX ! 2, • — --..—..__... --;—�-;,....... -.-.__�...._...---.—_ __-._......_ _. i _ - 1
Beach Bulldozing -- -- i
Other ( i y ., j I I
)n� I i ,,. •
Shoreline Length k !04- 1 ........s"" +.'.�'.'' ,; ,,', , ., 1'as'.1.y1;1—,e411 . �;�i_ �. E
..
SAV: not sure yes no ' __. 1 i —._ . . •
(' '
i
Moratorium: n/a yes no _ j i �y1t -- rLE �r�1<..._..._� .. f� �_.-........... 1 i --f, �___.._.............I-.
Photos: yes no 1-" 1i r..)., _I_ i j
Waiver Attached: yes no . . I I I 1
•
A building permit may be required by: 1/©W''+ 6 7" .47 . [ See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) 1 ff / /
Notes/Special�` Conditions iU7 / < l�r�ddlvr l G11v7rt.) /103/tik1, / lAt,41 a'f Ea7 Z' i1t.,c fo✓l)rt��iwti>c
l "t-�ia_r, t/1t, •r /-1,e/ . T4�12K14-, /I cJ? %a ` reeeJ /co' la i iii.,,. f Lam`-'-u a.- ,
12;e✓ '',...',' 01i won m i.- + . r)/ ",a►u-� otn ovilook •S;UP he ci?el< — cil1 `1`xr 4-4WTc- C -Q;mi.
utkh&ta t) wo, e 5 c e 1 f
Y-)j 1, 1JI5 (9U /GIfc 15 tey Co,.�,AN`DY
PA,Pas
ent or Applicant Printed Name Per tOf icer's Printed Name
//X cii) ►..._-
Signature) 1Ie Please read compliance statement on back of permit*,1 Signature , C-----)1'. ', / ii, / - C?c - -go�.1 --- 1 - Feb — 2 0
Application Fee(s) Check# Issuing 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:
n Tar-Pamlico River Basin Buffer Rules Other:
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 252-946-648 I
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. I27 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-390 I 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)
hitp://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

6GAMAr/, ;6REDGE & FILL t � c h'TQ
GENERAL- PERMIT �91� �y Previous A ��8:' C D
p mot /
[ 'New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued N I K\
As,authorized by the,,Sate of North Carolina,Department of Environmental Quality /
and the Coastal Resour`ces'Commission in an area of environmental concern pursuant to I5A NCAC (T /--• I ZD2 .
,,v _ l - L Rules attached.
Applicant Name C F1;i 44 L.1 Sr r' Project Location: County c:k.. ; ,r'
Address I C. 1-e-x-n G©A Cu tor'A . Street Address/State Road/Lot#(s). .
City - c4.\/-1 State NL ZIP .7"RO l?, ;,-v7/►iuc�cle. (4ox,.,", t
Phone#CDC') (_�L.. -S ZL E-Mail Subdivision • , ,(�x�t-
, • -34-- r 1�! r-k•``+
Authorized Agent 1-5' s Mart•-,-e- (vb1<17 ' City 1F71. IA ZIP,-)a, -'SQS
Affected ❑CW ❑EW R.PTA ❑ES ❑PTS ' Phone# ( ) River Basin 7/l R.I{(rl 1 Y•
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): - Adj.Wtr. Body lTif Ceet'k ,(na N/man /unkn)
O PWS: • •
ORW: yes '/ no PNA es / no yN l� Closest Maj.Wtr. Body `s jl,L. ,, 21‘-'c''�
Type of Project/Activity
T i�4 4fa)1 /._/X i#c/' .,i'-e r w r/I L L'�J fA /u , 1 ' L • .i'1 e',:;� ✓i {.a--
/
h (Scale: i ' "1.�,Ca' )
Pier(dock)length(o'X I S'-0' • 'L\
^}}y y I
Fixed Platform(s) 00R yr' 1 + j `fl. �s�. f'L t e�� �j4;�'Ct ��i ? �'1 t t2
'Floating Platform(s) I - ,^ F �(1 I° �, r L.k I j; I "}
Finger pier(s) ;r II 'a-V , -' L'•.i^iy!A ! 1 —
Groin length ( I I _ „I\\j. i r —*r- r l;,ik ,7'(
number __ -- - I j' �' -� - -----' ' i ----'- --
Bulkhead/Riprap length 1 -__i 1,4c. ',(r1= c q 3f �_- -
I—
avgdistance offshore ( 1 �' I • + j
max distance offshore I "i I S "� I ;-r'
-
Basin,channel
j`, ti ik, 1 i ,a I
• ( • ..-e--4.•<"..... f -
cubic yards ( 1 s' I
y i
Boat ramp ! 11 � I `-
1
Boathouse/_0B a�tl f )�'X 1 Z' ---- - -- -- —
Beach Bulldozing � - I + '
Other I
•
Shoreline Length - `yC I I t h ra F().
t I.: �� -"'w•-• R
At
SAY: not sure yes , no\ _.._ f _- __ __ _.._--
Moratorium: n/a yes no j Oki J ,,, c. I` lT I ).C__.__ �,,
Photos: yes no i. "'I"t.%1 ............. _ 1 T I r _�
I / i1 ! i ' ,
- Waiver Attached: yes no �•�°' ,a •
A building permit may be required by: /OLAJ ' ,,G /-i I>'See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) } `f
Notes/Special Conditions LU-r t S Ma;,,,Ia;.i,- /01,0i4, /.r,A,‘•+ ,'=''( 34TI ZcY,j r.,c C;41•5,vii•i-ic
1 T4 A r itl i P1 e f -}- 77/r .Gr.0-, ' 4 c., I-. / (Y(.i.F'cl) )c't' -A la I f,;o,,,--7g/ 1,,,d"'''to ce ,.
I.6 r ,k, ^' 01-1e.,fiin ol +2k rl r '7o,w4, a.. ,,7,0ei)( S')c" n f 'cit et &,)t '1"Xf1 4 f=1 C ' iU C' r;✓eri.
: / ' 1 1 . . 1 1 If/ diP 15cw\.,e a c� Lwa.- I S {I R 3 r r.
if!%Xr
Printed ame � - PepitO icer's Printed Name �/
66,
Signature Please read cd mom,pliance statement on back of permit , , ,' Signature /"
gl ., f^!/) / '3 / ./ .-{ -2021 - / - Feb 202.
z
Application Fee(s) Check# • ,' Issuing 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:
IX Tar-Pamlico River Basin Buffer Rules I Other:
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 252-946-648 I
Fax: [phone] Fax: [phone]
(Serves:Carteret,Craven,Onslow- (Serves:Beaufort,Bettie,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 9I0-796-7215
252-264-390 I 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

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 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.
a Pre-project site conditions: L of l f /j'�►r+ Ti((1.7.cd �Gvt _
By your signature below you agree to be held responsible for meeting all of the conditions listed above d v ify
that nformation pr ided is complete and accurate.
Ag t [cant P int d ame ermit O ' er's ignature
•
C7CA— Z-02-1
A ent Applicant Signature Issue Date
CAMA GENERAL PERMIT#: 3
State of North Carolina I Environmental Quality[Coastal Management
Washington Office 1943 Washington Square Mall Washington.NC 27889 1252-946-6481
• Wilmington Office 1127 Cardinal Drive Ext.Wilmington,NC 28405-3845 910-796-7215
Morehead City Office 1400 Commerce Avenue Morehead City.NC 28557 1252-808-2808

•
ADJACENT Rip fu ARJA PROPERTY OWNER STATEMENT .
I hereby certify tat I own property adjacent to _ ' - Cr- tp
..,.. wo ei?z,) c at3V.Propeizw,r) ;
propeRy located at • ern 0 a ,40 '
,
•
(Address,L i 11 . - .Roa., , sA - ,
on 8e in Ail e V4 t.,-1 .:, fir, rr- ,N. '.
(Waterhody) ' Cityfrown
! 1
' , 1
' I
-- ----- The airant has described to me, as shown below, the development proposed at the Rime
Iocati .
I have no objection to this proposal
_
• owner I have objections to this proposal.check ene
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must WI in skacription beim or affix/Te site drawing)- _---- -
,A
41464
M i WAIVER SECTION ami%
pro I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
Owner must be set back a minimum distance of 15'from my area of'loaden access unless watvei by
Must me.(If you wish to waive the setback,you must initial the aPProPriete blank below.)
Initial
one
I do wish to waive the 16'setback requirement.
160 I do not wish to waive the 15'setback requirement
(Prop Owner Information) (Adjacent Property Owper InformaSe ) _
d a f^ ..sve5...e......„KgeoyAl_ 69/90.0
Prl or Typ e Print ar TiyzAlaikaelp 6, .
0 iikt9 Pt-
4c4k) /1)C (97dres----- Mailhw ' i•ress
3 A R , (97406-•
c'e'llASP g‘,50 --Z1 17,3 cffyistaterzo
26-e--9y1--7070 eav ckefttvlied-A
Telephone Number/email address Telephone Afurnber I'email address [ I

AD. JACENT RIPARIAN PROPERTY OWNER STATEE• NT ' t t hereby certify that I own property acijeoent to„, ame of Preps :
proOerty located at a n . u - -
„
(AdOiest,L k oa -
. (Weterbody) (City/Town andfor County)
__—____ The applicant has described to Me, as shown below, the devetprnent proposed at the abOve
loc.auce
Adjawa N., I have no objection to this proposal_
Propfrtv
Owner. ____ I have objettions to this proposal:
check one -
. - DEscRipTION 414D/oR DRAvv------------- 3RoposED b Lop EVE [WENT
(Individital propcigtg develpp ft
mentalwaho-dasaripmert-belotaror-attactr a site ciraiying) --- -
-----
One
en
to-d/
,_ , :14._eej itibil
Ad ' ,5ec* -
bri °
ia /4(
. .
WAIVER SECTION
Aeljace44 I understand that a pier, dock, mooring plibm, 1--'—litiAtraino, breakwater, boathouse, iift, or groip
Prom*
Goner must be set back a minimum distance Of 15 from my area of riparian access Unless Waived bx
zzi me.(if you with to waive the setback,you must initial the appropriate blank below.):
aim
I do wish to wake the 15 setback'requirement. .
— - - .." I do riot wish to waive the 15'setback requirement.
: .
(Prope er n inflation) (Adjacent Property, r Informatio i !fi
' .
t .I f( 1 L• eAA
Pr! oi-Type e .
Pri etv- i.fsnis 00 0 6. c....ot;
0 A 1.1.00• :art—
.. 0 dims
0 C
_NA—ciaorz, i-pi
It) •
afaphana Number/email edvIrwa "
Telephone Numberierilsil address
Date-7----"--=------•.---
Date--
•
Olublaadlitig.Z074.11
'Valid for one calendar year after signature*
; ,

. f.
:Amthorized Agent Consent*j email
� 4 -
(Property Owner herby authorize Tobin Jay Tetterton of
T'J s Mamie Construction,$PLC'to act on my behalf obtaining�anf$tg GALA permits fo
the location listed below.
PROPERTY MD!PRESS:
PROPERTY OWNER'S
FAILING ADDRESS:
er
Phone No. odaril
PROPERTY OWNER'S SIGNATURE:
AUTHORIZED AGENT SYGNATUR1Ee
T B.INI T + RTON
DAT7Ea. ,� 2
,e/
W/Authored Agent Consent Agree.
1

....... .
TOWN OF BATH •
BATti, NORTH CAROR1NA
DATE ' -
BOOK Na PERMIT FEE PERMIT N .
APPLICATION FOR: BUILDING PERMIT( ) zoNING COMPLIANCE CERTIFICAT ( r
,
Name &License No. Address:
Ph ne,No.:
......,-,-
/36 Feivi.00oet al-
CONTRACTOR 'drisnt alio 0 x ic, .5-..2- ' -166'7
DESIGNER
SURVEYOR
ELECTRICAL
• PLUMBING
TYPE 4 P IMPR*VEMENT
•
NEW•(• t)-- ADDITION ( ) ALTERATION: INSIDE.( ) REPAIR; INSIDE( ) MOVE ( j
OUTSIDE( ) OUTSIDE( ) LOCATE 6 )
Lot No. Block No. Building located at
betinfeen and
Streets. Building to be sed
. f cti i. .—
. • Type Construction ier A 1-Air Q.y . V41
It e°A
Number of off street parking spaces_________. Contains rooms and
Total square feet of building Electric Setvice___________. TyoL 01 heat
' .
, .No.of plumbing fixtures . Foundation bl sk caps ;
'1"( ) 8"( ).Corner bracing:Piywood ( )other •
-m-"wagni riclur - t'
Walls ceiling Windows:Storm( )Thermo!( ). How many exterio doors
Water Heater: Gas( )Electric( )Other
Roof Ventilation: Gable( )Eaves( ), Louvers( )Other • Ventlia on
crawl Space, number of feet apart . Height of crawispace under house: 18"( 24' ( ), :
Other__ ___, zone • Water and Sewer Ta Paid( )N/A( )Size wafer tap
1 - '
size sewer tap: Total Estimated Cost Rood elevation I ..
1

BUILDING INsPEcTION DEPARTmENT COMMENTS:
a 44,44,z •
Ajds 77 54i — 4"V 45... "or-49 AV
fidoo-kc2p-zea . 1 /r
GENERAL COM NTS: ./ 114 • --6" l, irt/ip
A ..(a? #ar;Id e 446/
'0;er c e Year- h
awzr-.4
4471Ararroj e* 4o
CITY LICENSE NUMBER:LaeL_
Contractor/AC
an Plumber/ilea Ong
Application approved by:
7-a
The owner of this building and the undersigned agree to conform to all applicable laws of the TOwn a
Bath North Ca l'
•
•
ignature a Applic.ant
Effective 8/10/04, there is a$50.00 filing fee for all permits, including zoning compliance application.
Any conA)struction that requires installation of water or wastewater services may:
Be installed by owners, con'cactors or
B) Be installed by Town of Bath Utilities Department
All components must be compatible with existing water/wastewater materials, including myers Pups.
Bath Utilities Department must inspect au construction prior to services becoming operational. InSpection
fee is$100.00.
• •
1

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BeaufortCounty, 1 V l GPIN:6643-99 4740 LAND VAL:150000 DATE:3/19/2021
GPINLONG:6643-99-4740 BLDG VAL:0 DB_PG:2058/00112
NAME1:HAUSER JOHN R TOT VAL:150000 STAMPS:464.00
Disclamer: NAME2 i HAUSER JANE ID
TAXABLE_VA:150000 SALE PRICE:232000.00
Beaufort County online map access is provided a a public service,as is,as ADDRl:2719-B S SHORE DR DEFR VAL:0 REID 1:4628
i available end without warranties,expressed or implied.Content published on `
his welxito Is for nfocmetioaal pu poses only and is not intended to cons irate a CITY:SURF CITY PREV ASSES:300000
legal record nor should it be substituted for the deice or services of industry STATE:NC ACRES•0.73
professionals.The County of Beaufort and the Vhbsite Provider disclaim all '
�. respaosibillTyand legal liability for the content prblishedon thiswebsiex The ADDR2:2719-BSSHORE DR PROP_ADDR:FERNWOOD CT
Y' user sprees that Beaufort County and its Arsignsatmll beheld hamilcss from oll ZIP:28445
t actions,claims,damages pi-judgments arising on ofthe t��e of Cowety data. , TOWNSHIP:07
j� beaufortne.agdmops.wm __PIOP DESC:LT 3QBRIDGEWATER_MBL.:_66440088__-__ _—___.—____-_ _[______—_.
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5'
N.C.DIVISION OF COASTAL'MANAGEMENT -
ADJAGENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
• CERTIFIED MAIL - RETURN RECEIPT`REQUESTED or HAND DELIVERY 1
crop portion o_`becompletedby.ownerortheiragent)
a� .
Name of Property Owner.' !`� � �(A,�C�. _ --
Address of Property: I3 0 /'/711)®OCi 6 (;U1i7`'
CYq' �
Mailing Address oftt r.Owne ! ., ¢
Owner's em_ail j011llfhQ4sCr� [ •M et---
Phone#:.`To 6s56 "`0c7�
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Agent's Name; .`s-4Cf;4 C4i/15t. a Agent Phone#:& c2" 913-47 V .
Agent's Erriail: bih A fS/IC± Haim i
ADJACENT RIPARIAN PROPERTY'OWNER'S CERTIFICATION
(Bottom portion to.be completed by the Adjacent Property Owner) ,
I herebycertify that!own. ,roe adjacenttotheabove referencedproperty,The individual applying yfor this
►�Y P P riY ,
. permit'has described,to me; as shown on-the attached drawing, the development they are proposing. A
desc potion or.drawinq,with dimensions.must be provided with this letter.
• I DO NOT have objections to this proposal. -I DO have objections to'this prop OsalJ
If you'have'objections tb what is being proposed; you must notify the N.C. Division of Coastal
Management(DCM)in Writing within 10 days of receipt of this notice Correspondence should be
mailed to 943 Washington Square Mal!, Washington,NC 27889. DCM representatives can,also be
contacted at(252)946-6481.No response is considered the same.as no objection if you have been
notified by Certified Mail.
i
WAIVER SECTION
I understand that any proposed 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
(this does not apply to bulkheads or riprap revetments).(If you wish to.waive the setback,you,must,sign
the appropriate blank below-) 6 .
I DO'wish to waive some/all of the 15'setback . /,? •
�Js,
Sign a re of iacent ft anan'Propei ty Owner.
-OR- '
1 do not Wish.to waive the 15'setback requirement(initial the blank)
i '>
Signature of Adjacent Riparian'Property Owner. i /f044.tt
Typed/Printed name of ARPO: iree a ig"e 0
Mailing Address of ARPO: /a re,nttiip .fit ØIt AA ?elbef--"
ARPO's email:0600M MI6 IfeARPO's Phone#:OI5G7 T '9 7
Date: /ej. h ;11 • *waiver Is valid for up to one year from ARPO's Signature*
Revised July 2021
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, . . • . . . • : • (Top portion to be completed by owner or their agent)
Name of Property Owner:
• ;:3 ei • .,,,„ ,,,,, ,,,,, 7,,,,- Aie
•. ..
_.
•
Address of Properly L,Z ___ 4., c..,./Z. ,,ct..1.... efli: LIJAiir74' . '
i
• •
- . . : ' • Mailing Address of Owner :_ '_,.._ c.:......1. ......e--____.. -:------ . — , --- •-
Owner's email-. A h at4OLscircitct ' it itrier's Phone#: gifO —6(56
. . .
' .
Agents Name:.17.46,,d_e_lamit
-.,ae. Agent Phone#:4.512- 7:9:,...?''-'‘6 '7P-
..:
• • Agent's Email: Thbilf)4 r75(161; 0 i'L_JC
1 i • •
•
...-....,...,....,„........_. __..—..-'- t ,
. .
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
. .
(Ei_i:,...ttoi....2pn Mon to be completed by the Adjacent Property Owner)
: .
„ .
, .
, . . . ( I hereby certify that I own property adjacent to the above referenced property.The individual applying for this
. •, , / permit has described to me, as shown on the attached drawing,the development they are proposing.
• .: ', •12;\ „." description or drawing with dimensions must be provided with this letter.
;,..\ .'t) - c..,). ils:),:5.•ki DO NOT have objections to this proposal i DO have objections to this pr8pOsal.
(
, • . ( If you have objections to what is being proposed, you must notify the MO.Division of Coastal :
Management(DCM)in writing within 10 days of receipt of this hotice. Correspondence should be
4,-
mailed to"943 Washington Square Mall,.Washington;NC 27889.,DCNI representative*can also is
. . :• . contacted at(252)946-6481.No response Is considered the same as no°Weeden if you have been'
notified by Certified Mail.
, . . .
i-•:•
. . .
,
t , • • .
. . • WAIVER SECTION • ' "
-: • : . .I : . i understand that any proposed pier,dock;mooring pilings,boat ramp,breakwater,beathoUse,ilk or
:,' . .: • T.' . -. .groin must be set back a minimum distance of 15 from my area of riparian access unless waived by me •
(this does riot applylo bulkheads or riprap revetments).(If you wish to waive the setback,you must sign • . - .
,
.• . . - the appropriate blank below.).
.,,'....--.H--"--------:- .--' -T. --- errielall-Of the 166'ailliaCii. '' - ' - :
Si nature cifacent Riparian perry Owner
, :. •,
_ -
• • • " • •• 1 do not wish to waive the 15'setback requirement(Initial the blank)
. .
. .
: .: • L'ON4 - -1,04T-t : ' : .
0 tc _l11Z02._
. .
- . . tplifp.A.ofAdjadept Riparli,Eln.174-.0pe ClWner . . .
' .. • , - - • '.. • ,.. '-Typed/Printed name of ARPO; 111,421
r)t
- . ..
' ' . '" .':.- '-' . .,• .. :Mailing Address ot.ARP 6:761--Ciyi 001 07.: (14")/4 itec g:17.2'00°-.0 ,--.-- . '• .-i.q
:ARP0)9 email:kkjil'iltge*s(MC. ii itirt(14140's Phone#:49 ;3/7<10,07
- .. • ,- . ,,: : , :,': -- 1:3.6.‘,:..:./1 '!*or! "i. 'l'IAi'alkfer le valid for agi.te One year from ARPO't SIgnataya;'
" ' " ' ' - --• • • • . . ROtOefi July 2021 ,. ...,. • . • . . . . . ,. . . . .

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Grandy, Ashley
From: Bubs Carson <[e-mail]>
Sent: Tuesday,October 12,2021 8:29 PM
To: Grandy,Ashley
Subject: [External] Re:John Hauser permit
CAUTION:External email.Do not click links or open'attachments unless you verify:'Send all suspicious email-as an attachment to
Report Spam.•
Ashley,
I discussed the pier in question with the contractor, (Toby Tetterton) and learned the pier decking material
comes in l0.foot concrete sections. When the final section was placed in position, it exceeded the permitted
length by several inches. After discussing with CAMA officials,the Town will not require modifications to
shorten the length.
Thanks for your assistance,
Bubs Carson
Town Administrator
i