85278_Jason Annis_20220622

,to ` DCAMA DREDGE & FILL TR�K� �] QQ N9 85278 A`V'B' c D
a ,J-)# T O 6 co.,,, Previous permit
3 : GENERAL PERMIT
Date previous permit issued
n1Vew ❑Modification n Complete Reissue n Partial Reissue
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 n Rules attached. O General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s)
Phone#(_)
Email Subdivision
City ZIP '
Affected n CW 1 EW n PTA n ES n PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): OEA n IHA n UW n SPIMA n PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale:/' ;,)
Shoreline Length
Access Length i 1 I -- L-I - L+r
r. Lti - p F Cf tf r
Pier(dock)length i ' 4--_____.�
Fixed Platform(s) • /
r - I
Floating Platform(s) - I 3 ' - - 4
- r - ----- - — - --
Finger pier(s) �.: 1 I ,,..k sin,. g,. F''+... (-o,,
�........ i — j
Total Platform area i 1 1 I �.� ��
Groin length/# 1 - : . ' 1
'41-- S 4. ,i .. .. }- _
Bulkhead/Riprap length - ------ -- -----I- ,
Avg distance offshore':1 j-• 4---r--
Breakwater/Sill
Max distance/length ; - Y 7.> I '
i -
Basin,channel j i
- _ - .._._J`.._..---
Cubicyards • — -r• j. - �__j .....__..._._._ .....
I I. _..-Y _—.
Boat ramp
Boathouset Boatlift
Beach Bulldozing
Other
SAV observed: yes no f
Moratorium: n/a yes no , "j\; y.<<it._-, -At 1'(A h Site Photos: yes no '`�'� t -IL-.
Riparian Waiver Attached: yes no i� P 'lit, 7- I!' i ' j I -a
A building permit/zoning permit may be required by: r'
Permit Conditions n TAR/PAM/NEUSE/BUFFER(circle one)
%; 0 See note on back regarding River Basin rules
nSee additional notes/conditions on back
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial) ,
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name .
Signature**Please read compliance statement on back of permit** Signature
IDS .
Application Fee(s) Check#/Money Order Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit 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: 1) 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 from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(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 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. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/ 1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret,Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St.Ste. 300 127 Cardinal Drive Ext. Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie,Camden, Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

O`°"'`"`4^y CAMA n DREDGE & FILL -4:,) �� N9 85278 ABCD
= GENERAL PERMIT �L # � 0 9 � ? Previous permit
Z Date previous permit issued
> ' I I New I I Modification Complete Reissue [ I Partial Reissue
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- General Permit Rules available at the following link:www.deo.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s)
Phone#( )
Email Subdivision
City ZIP
Affected CW [ I EW PTA ES I I PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): ()EA 1 1 IHA UW n SPIMA PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale: )
Shoreline Length
I .
Access Length ✓__._.._. ._.....___ �..___. ,_-_T ,'
Pier(dock)length i (
Fixed Platform(s) i j j ' "
I
Floating Platform(s) 3 . —
�� 1- L._
Finger pier(s) • p.. I 4 _. c - ,I
I
Total Platform area ( i ,I
Groin length/# : _ I A --1— i
Bulkhead/Riprap length —I — —
i _.... ....... .._..�_ I t— __ �_
Avg distance offshore i
1 - ;
Breakwater/Sill
Max distance/length ! ` '
'1:
Basin,channel ' I ! d
i I
Cubic yards
— — .. --� L._.., ....�._._ --_ .....� ..
Boat ramp ( —,— i yy i j - _.. ._......
Boathouse/Boatlift t i 1
Beach Bulldozing ( * i I
r '
i
Other }
. i _ t. i I
SAV observed: yes no I j j I
Moratorium: n/a yes no ' .r.?"—'i `...1'" "'- ' --q 1, 4 r ' ..
Site Photos: yes no $ I i :,= i=
Riparian Waiver Attached: yes no I I PI.'- I G +Z: I'-' I "
A building permit/zoning permit may be required by:
Permit Conditions TAR/PAM/NEUSE/BUFFER(circle one)
See note on back regarding River Basin rules
See additional notes/conditions on back
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
Application Fee(s) Check#/Money Order Issuing Date Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit 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: 1) 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 from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(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:
MTar - Pamlico River Basin Buffer Rules 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. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889
252-808-2808/ 1-888-4RCOAST Fax: [phone] 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River,Onslow Fax: [phone]
Counties) (Serves: Beaufort, Craven—north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Elizabeth City District Wilmington District
401 S. Griffin St.Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax:[phone]
(Serves: Bertie,Camden, Chowan,Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

ROY COOPER.
' ,.t Governor
MICHAEL S. REGAN
Secretary
Coastal Management BRAXTON DAVIS
ENVIRONMENTAL QUALITY Director.
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS 'NAY
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 1SA NCAC 02E1.0233 & .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-pr ject site conditions: (13 1 S i., }j,..- /(:2 -'4--1
kJ( a
By your signature below you agree to be held responsible for meeting all of the co ition listed above n v fy
that all information provided is complete and accurate.
a t
Agent or App' nt ' ted Name Pe mit Offi s Si atur
• 77) Z4Z2
Age plicant Si e Ile Date
f AMA GENERAL PERMIT i#: 5 5 $ -5
State of North Carorma I Environmental Quality i Coastal Management
Washington Office I 943 Washington Square Mat Washington.NC 27889 1252-946-6481
W lmington Office 1127 Cardinal Drive Ext.Wilmington,NC 28405-3845 1910-796-T115
Morehead City Office i 400 Commerce Avenue Morehead City.NC 2855? 1252-808-2808

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner. J a or 1‘4 i1(L 11
Ova,K\llLA Q Ajc.. t)eo&
Address of Property: ICr. �nlh 11
Mailing Address of Owner. ScMt rl� d UOJc
Owner's email: vv./Ye-cnA Cr na @ fAttuwner's Phone* zs z_ 3 Z 7 - y�
Agents Name: I /✓'4 Agent Phone#: 'v -4
Agent's Email: NP
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent 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. A
description or drawing.with dimensions, must be provided with this letter.
/C I DO NOT have objections to this proposaL I DO have objections to this proposal.
If you have objections to 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. Conospondence should be
mailed to 943 Washington Squa►eMail,-Washington,-NC•27889:DCM:representatives-can also be
contacted at(252)9484481. No response Is considered the same as no objection if you have been
notified by Certified Mail.
WAIVER SECTION
I understand that any proposed pier, dock, mooring pilings, boat rarhp, 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 skin
the appropriate blank below.)
I DO wish to waive some/all of the 15'setback
Signature of Adjacent Riparian Properly-Owner.
-OR-
I do not wish to waive the 15'setback requirement(i • I the blank) =�—
Signature of Adjacent Riparian Property Owne f4
Typed!Printed name of ARPO: gel / fltcThT%
LPTA
Date: S c>Ch 'waiver Is valid for up to one year from ARPO's Signature'
Revised July 2021

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N.C. DIVISION OF COASTAL MANAGEMENT' x. - 'Vz = '
_ ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
•CERTIFIED MAIL • RETURN,RECEIPT REQUESTED or HAND DELIVERY
(Top portion^ti to be completed by owner4or their agent)
Name of Property Owner:` \, 11.4.1•, flint%
g k.tit,� tA1S4 Nc z� s
Address of Property: '.� !!� OA.
II
Mailing Address of Owner. S‘Arge. AS p ball, - _ _..
Owner's email. r><n.P It C.ra)in=Cr nr f u wner's Phone#: . :21 t 327,.-SZ9)
•
11 '�N
Agent's Name: 1�n% U vvb a,� Agent Phoned: 2 L_ y of 6- (40"
Agent's Email: k. U aw1I% (4) tRL AeU it. 9 u
ADJACENT,RIPARIAN PROPERTY OWNER'S CERTIFICATION _, _- -
-,- (Bottom portion to hi completed till the Adjacent Property(lwner) '
I hereby certify that I own property adjacent to the above referenced property.The indMdual applying for this
permit has described to me, as shown on the attached drawing, the development they are proposing. A
description or drawing:.with dimensions,must be provided with this letter.
xI DO NOT have objections to this proposal. I DO have objections to this proposal.
If you have objections to 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 Mail, Washington, NC 27889. DCM representatives can also be
contacted at(252)9484481.No response la considered the same as no objection if you have been
notified by Certified Mali.
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 skin
the appropriate blank below.)
DO wish to waive some/all of the 15'setback.
Signature of Adjacent Riparian Property Owner
-OR-
I p1A-
do not wish to waive the 15'setback requirement(initial the blank)
• c ;
t
Signature of Adjacent Riparian Property Owner. T M{���� w "'
ed►Printed name of r pa t1 % 'nymoto ' ,� , w (''i (
TYP ,,. fry rr „
MaltingAddresaofAsO ` " . . 'Av�i Blvd. invrll� ' . < r 'I
kk r
ARPO's e1maiF A�k � 0 s' honed 1 =Sal=Wait)
Date: Ii.l alga 'waiver Is valid for up to one year from ARPO'a lgnatuie•
Revised July 2021

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- — •
STATE OF NORTH CAROLINA, . . . . ve No.
•.
• . 20E512
P
a '"' •. ;.' t - ‘: a-; . '-9---,— - in The Geheral Court Of Justice
Cot:Intl/ ..--,",.... ...1-...., : s }..(.. ..,. . -.. • fr,....._-,,, J pupenor Court Division
Before the Clerk
IN THE MATTER OF THE ESTATE OF: - .
Name .
DAVID LEROY CARVER,SR. - . --- . ---- , -- . . - • LETTERS . .
OFADMINISTRATIONCTA
,.
G.S.2846-1;28A-6-3;28A-11-1;36C-2-209
The Court in the exercise of its jurisdiction of the protiate of wits and the edminietritiOn of eitEitei, and uribn aprilication of
_ _ the fiduciary, has adjudged legally suffidient.the•qualifibation of the fiduciary nagtetil belowarid,orders.that Letters be
issued in the above estate. --,
, .
, . . ,• _
The fiduciary is fully authoiljz: bithe Iiiidoi NOittibaiOrthacit receiVeailrldirditiinisterf ell of the assets belonging to the
estate, and these Letters ireiistirecitiifteif6iiiit`iiiitiiiiitiiiid:Weartifir thAI it igitik ifiluil force and effect
-1_._, . ..-t-., - -!,---, : P::
Witneilaijihand and the Sealof the Superior.Court - .._
. • • ___...L.__.:—i---0.—.-.. 7 —
•
' •
Name And Address Of FIclucimy 1
1698E.Arlington Blvd. '
Greenville,NC 27858 Cfmk Of Superlort.owt 4/al20eRa.
-.
Title Of Fiduciary 1 Oil; ,.• , - V.Martin Paramore
% tiwn"*"' • • Ex OFFICIO JUDGE OF PROBATE
Name And Address Of Rductaryar2gt;:c7'''; Pk; i '' ! . . 7 ,' Dam Of issuance
_1jr.. - 2..?; 2t#4::. ...:„;:el .a
. ...,.c...,A, 02:7,4,.‘ ' ; : t :5; : Signatulp " - -
: : .515.'S. —21,1- I - — (Asa" 1,"iii ',-->,-- ':.- - ' fifiti .-ifiirnicisi: :-:--:
lit
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. ._ .. .._.... . .... —___......._
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-- ' t'I ...3 • ....'- ‘7851;11if
NOTE:-ThisAitteils Ild4- i ...-is the official seal of the Clerk of Superior Court.
t .
AOC-E-403,Rev.7106
02006 Administrative Office of the Courts

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TOWN OF BATH
BATH, NORTH CAROLINA DATE G -!a - Zv
BOOK NO. PERMIT FEE 50- _PERMIT No.
APPLICATION FOR: BUILDING PERMIT( ) ZONING COMPLIANCE CERTIFICATE ( ("1"
Name & License No. Address: Phone No.:
OWNER
a il\ (2- .133 �) 1 - iL, Lill1re Q , WI /li ,
,
CONTRACTOR - 1)
DESIGNER NO
f
SURVEYOR C"AkkA
ELECTRICAL 4/ (A
PLUMBING /VIA
TYPE OF IMPROVEMENT
NEW ( ) ADDITION ()6, ALTERATION: INSIDE ( ) REPAIR: INSIDE ( ) MOVE ( )
OUTSIDE( ) OUTSIDE ( ) LOCATE ( )
Lot No. Block No. Building located at _ \\
between l�t/LVfS- _ and t"CA GO L•ta..! Streets. Building to be used as
. Type Construction Q4�� -4ay.ran:,.l —
Number of off street parking spaces . Contains rooms and — bath(s).
Total square feet of building , Electric Service Type of heat
. No. of plumbing fixt -s . Foundation block caps
4" ( ) 8"( ). Corner bracing: Plywood ( ) other . Insulation: Floor
Walls , Ceiling . Wi•.ows: Storm ( )Thermal ( ), How many exterior doors.
. Water Heater: Gas ( ) Ele. is( ) Other — — —
Roof Ventilation: Gable ( ) Eaves ( ouvers ( ) Other - Ventilation
crawl space, number of feet apart . Height of crawispace 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 INSPEL I ION DEPARTMENT COMMENTS:-Z Q u Ki io,r' ( t p o A.) /A\l,o4.-tx S-9
FOE.- e Y-ar r,v,.oc . —n-tr5 G°N5--Tx-uC-17 c-lt�;�s
t f-- -S rbE�TI Al_ �4-1 PI/a,0- /4/
j . -Des77L(G j
GENERAL COMMENTS: li 11tM1K� a /�'f u4- Ar(( ci�kNN
P- �� w�w�� �7i 4.V1_ " moa,i / L )�. VJuK� (�"T
A1 1✓Cy
a A-\nt ot.�k, C.A A -1\ ti�� S►r A Mty1 1 rL✓n1✓�Y
CITY LICENSE NUMBER: --
Contractor/AC ician Plumber/Heating
Application approved by: /da.•",,-) 0.4-( -
The owner of this building and the undersigned agree to conform to all applicable laws of the Town of
Bath, North C lina.
Signs e of Appli ant
ective 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.