31853D - Holland

L,tAMA / DREDGE & FILL N 31853-')
ii::11
GENERAL PERMIT Previous permit #
New Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC dig I cLO°
' _,Rules attached.
Applicant Name le VIf"tt`(I A N l) Project Location: County - (fin/j,u i,.
Address I +f(v it, la Ave __- - - CC Street Address/State Road/Lot #(s) . i'� p "/li/V LA/
City /1./l)l ', 7/ State NC ZIP e,7&yw U
Phone# (")) 135 J7 Fax# ( ) Subdivision Authorized Agent______ZzAL City5i{/t7 S N/02 l/ vi) ZIP3St(b U •
;y.CW DUN,/ tt rPTA LiES PTS Phone# ( _) 3 i.--- 7 1 , River Basin /4444.1r, Ort K
Affected ❑DEA ❑HHF ❑IH ❑UBA N/A
AEC(s): Adj.Wtr. Body F"//446 (ke e- nat an /unkn)
❑ PWS: ._FC:
ORW: yes / no PNA c'no Crit. Hab. yes / no Closest Maj.Wtr. Body N�� 1�1 Pk
Type of Project/Activity P,' 11,01 P f""► Pk
t (Scale: / r1j/O )
' 70
Pier(dock)length C// i is
Platform(s) 1rn 0 1
Finger pier(s) F• / �'Lt / J
•
Groin length . �� 7 ><- < Air ~ tfC` K ��
number *,
`
Bulkhead/Riprap length /I 1��J
avg distance offshore 55 b
max distance offshore 1 130'17 t ') 5 f.
Basin,channel l `
cubic yards � �f f
1
Boat ►� j 1 f}-/.tfU�S., t
yi / . NAP S
Boathous Boatlift !
- t-. ' 1(f 3 /.. ;
Beach Bulldozing -
Other
( --- 2
Shoreline Length _ Q (_
•
SAV: not sure yes no - -- ----.__ _ 9 e
Sandbags: not sure yes no
Moratorium: n/a yes no
{
Photos: yes no
Waiver Attached: yes no j--
A building permit may be required by: QR)Sj-w eta • . 7 See note on back regarding River Basin rules.
Notes/Special Conditions P - ' ,S////// ,,o t e!'/P ) 24 S 1 Q(41--Pr F/Y,E & iS I /w1 0 i'?-Q
r'�11 ,
1
Agent or Applicarit Printed Nameii, Pe I is ignature 6
- 4.-f .L /— l:`�" ! d '' °c� /Jl- C, (}
Signature's 4?,Please read compliance statement on back of permit" Issuing Date Expiration Date
,; ,, C-o . 'c� 8 )`//7�}- -
I Local Planning Jurisdiction Rover File Name
Application Fee(s) /O 0,CA) Check# /x / g

4-
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:
j 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 Quality. Contact the Division of Water Quality at the Washington Regional Office(252-946-648 I)or the Wilmington
Regional Office(910-395-3900)for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District Washington District
Mailing Address: 1367 U.S. 17 South 943 Washington Square Mall
1638 Mail Service Center Elizabeth City, NC 27909 Washington, NC 27889
Raleigh, NC 27699-1638 252-264-3901 252-946-648 I
Location: Fax: [phone] Fax: [phone]
(Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Bertie, Hertford, Hyde,
Parker Lincoln Building
Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
2728 Capital Blvd.
Counties)
Raleigh, NC 27604
9 I 733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: 9 19 733 I495 15 I-B Hwy. 24 127 Cardinal Drive Ext.
Hestron Plaza II Wilmington, NC 28405-3845
Morehead City, NC 28557 910-395-3900
202-808-2808 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Carteret,Craven,Onslow-above Onslow-below New River Inlet-and
New River Inlet-and Pamlico Counties) Pender Counties)
Revised I0/C

CODES FOR AEC DESIGNATIONS
"OH" - Ocean Hazard "PT" - Public Trust
"EW" - Estuarine Waters "CW"- Coastal Wetlands
"ES" - Estuarine Shoreline "FC" - Fragile Coastal Natural/Cultural
"PW"- Public Water Supply "OR" - Outstanding Resource Water
•
CODES FOR PROJECT
"P" - Private-usually an individual "F" - Federal
"C" - Commercial "L" - Local Government
"U" - Utility "H" - Housing Development •
"S" - State "0" - Other
# CODES FOR PROJ DESCRIPTION
"11" - Bulkheads,Riprap "16" - Utility Lines
"12" - Piers,Docks Boathouses "17" - Emergency Repairs
"13" - Boat Ramps "18" - Beach Bulldozing
- "14" - Wooden Groins "19" - Temporary Structures
• . "15" - Maintenance of Basins, Channels,Ditches _ -- --- — - -
GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: ,ass F Ho/1-4 ND
ADDITIONAL NAMES: 1016 . _ ,D28S
/a�9 : ico -
AEC DESIG: (A) E(A) PA DEVELOP AREA: , 0 _ PROJ DES C: P -
(Will only take 6) (Will only take 1) •
WORK: P X q ) 13S /C' X is-
-
'. (Will only take 4)_ .
L 10X3O RL 13x13 z_ —
MAINT: -
(Will only take 4)
IMP: 0 ,d�'(0
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED:
CAMA MAJOR DEVF.T,REQUIRED: 8-o -G Z I I- - o Z

•
•
CSR 1518
' !ANY APPROXIMATE WETLAND DELINEATION
'OR APPROXIMATE;MEAN HIGH WATER LINE
SHOWN IS NOT CERTIFIED & IS SUBJECT Z
TO BOTH REVIEW do FINAL APPROVAL BY ,yNt n
b 'CAMA & THE U.S. ARMY CORPS OF
ENGINEERS. I G59"• Z j0
13 oaf `-,� a.-.—.- p�k ',�3°
i 1 o Sy
(/ /o�' ' l b'X �'�, SITE
I �1LARD CREEK
LFULLRD CREEK
/��GUr VICINITY SKETCH
a�tti NOT TO SCALE
0" I
I
EIP S86'13'55'W 78)1' 'EIP
APPROX. 13.10' APPROX. MEAN_
WETLANDS WET_J�NDS 13.30'� HIGH WATER LINE
LINE • • •— '�•
— — — TO to
�
0— — -- — —o IP r,5 30' CAMA BUFFER
d d
I‹ p0 CD
M :IP°Z
r.
W
N — -1 — — 73' AEC LINE
1 I ,
CT)
-
I 1.1
NOW OREBFO�RMERLY o I I-lo,vse I,
*
D.B. 1648, P. 680 I -tO$66 N
O EIP„
`1I I U `- ONSLOW COUNTY FIRM INDICATES THE ENTIRE
Q ,f;;•, ''•-••< PROPERTY LIES IN FLOOD ZONE "C", HOWEVER IT
• .'1 N IS MY OPINION FLOOD ZONE "A(8)" & "B" UE
EU7 N d' WITHIN THE 75' AEC ADJACENT TO FULLARD
cn ( CREEK.
bp0 5 C- .• 4-
16 1 i ,i j
II ; o
`- / ti• I
TRACT TWO w 03 (1 o NOW OR FORMERLY
23,116 SQ. FT. o to 1 ; z
CD I - MONTGOMERY
0.531 ACRES o �!� g.B. 1024, P. 190
in —50' M.B.L.
o I� PH1ve.v�aY
I,
r%
OEIP S84'39'08"W OEIP S84'40'38"W EIPO fL EIR N,94'44'54"E EIP
O
87.78 76.00 N84 41 15 E 76.04' 383.45'
S85'24'49"W C/L ASPHALT / N84'51'46"E O\ N84'50'33"E N87'34'17'E
EPIC 550.14' EPK 76,10' EPI< 99.44' EPK 830.599
IN CENTER F EPK
CUL-DE-SAC N,C.S.R. 1519 - ENNETT LANE 505.15'29"E
So5'07 27 E 50' R/W (ASPHALT - PUBLIC) 24.99'
24.76
. LEGEND
REFERENCES ECM = EXISTING CONCRETE MONUMENT (FOUND)
EIP = EXISTING IRON PIPE (FOUND)
D.B. 1024, P. 190 EIR = EXISTING IRON ROD (FOUND)
D.B. 1648, P. 680 EMN = EXISTING MAGNETIC NAIL (FOUND)
D.B. 1713, P. 111 EPK = EXISTING PARKER-KALON NAIL (FOUND)
F- M.B. 34, P. 50 • ERRS o EXISTING RAILROAD SPIKE FOUND)
w SCM = SET CONCRETE MONUMENT CONTROL CORNER)
SIP = SET IRON PIPE
5 THIS IS TO CERTIFY THAT THE SUBJECT PROPERTY _ - SIR = SET IRON ROD
IS LOCATED IN FLOOD ZONE "C" WHICH SMN = SET MAGNETIC NAIL (CONTROL CORNER)
u IS NOT A SPECIAL FLOOD HAZARD AREA AS • SPK = SET PARKER-KALON NAIL (CONTROL CORNER) ,
r, DETERMINED BY THE DEPARTMENT OF HOUSING AND R/W = RIGHT OF WAY
42 URBAN DEVELOPMENT. COMMUNITY PANEL NUMBER ENNETT LANE =
nCENTERLINE
�__31Q_ZA 94:0._D NQVEMGER_4 1992 MBL=MIINIM_U L UILDING LW1E
FROJECT RUMBER _..,
.- BOUNDARY SURVEY FOR
•,,• I, CHARLES FRANCIS RIGGS , PROFESSIONAL LAND 01-06-12
SURVEYOR, DO HEREBY CERTIFY THAT I HAVE JEFFREY S. HOLLAND
SURVEYED THE PROPERTY TAS^SHOWN^HEREON IN DAM

Evelyn Weber
1104 Martha Drive
Monroe,NC 28112
Ref: CAMA PERMIT NOTIFICATION
Please find enclosed a survey that shows the location of a single family home with boat house,dock,lift,
ramp,and rip rap I propose to build on a lot near you property. •
If you have any questions or concerns about this proposed development,please contact Jim Gregson at
N.C.Division of Coastal Management,[phone] or myself at(910)328-2273.
Thank You,
Jeff Holland

B.P.Montgomery
2596 River Run Road
Prince George,VA 23875
Ref: CAMA PERMIT NOTIFICATION
Please find enclosed a survey that shows the location of a single family home with boat house,dock,lift,
ramp,and rip rap I propose to build on a lot near you property.
If you have any questions or concerns about this proposed development,please contact Jim Gregson at
N.C.Division of Coastal Management,[phone] or myself at(910)328-2273.
Thank You,
/94/.../C-
Jeff Holland

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to JC FF t oLLAf\16 's
(Name of Property Owner)
property located at 2_ LNI NI CCT Lee
(Lot, Block, Road, etc.)
on PJLL o , in VNISI.b N.C.
(Body of Water) (Town and/or County)
He/she has described to me as shown below, the development he/she is proposing at
that location, and I have no objections to his/her proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
•
Signature
Print or Type Name
Telephone Number
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to JL- a-L \ b 's
(Name of Property Owner)
property located at GN 1 G T r LSE'
(Lot, Block, Road, etc.)
on P-VaLA- Lb , in ZWst-okiJ , N.C.
(Body of Water) (Town and/or County)
He/s,he has described to me as shown below, the development he/she is proposing at
that location, and I have no objections to his/her proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
SeE SuR e`-,
Signature
Print or Type Name
Telephone Number
Date

•
` ANY APPROXIMATE WETLAND DEUNEATION N,C.S•R.
1518
OR APPROXIMATE MEAN HIGH WATER LINE •
SHOWN IS NOT CERTIFIED do IS SUBJECT •
p �t(� TO BOTH REVIEW & FINAL APPROVAL BY y,.0 p
to
k v....0,
CAMA & THE U.k. ARMY CORPS OF �'� A
ada ENGINEERS. �G5•
4
Q.
ch p oa1X3o1 .
I ' !6 'X ��•' SITE
FULLARD CREEK
LFULLARC CREE
1 VICINITY- SKETCH
cohG►^t/re'arxIC_ !'1)01O NOT TO SCALE
Rif' Rap wall
o w'+ (�orr�p
P S a9'13' . It r'le.
71APPROX. WETLANDS ~'G7�' ,Y ¢ �F � • EIP APPROX. MEAN_
UNE • �� ✓ � � HIGH .WATER UN
t107.jr.r)__\\.3
HI . .
___ _ N)�O` \� o 00CAMA---- BUFFER Lo
t� --
Co o
M A
EIP0NW
N I i}
_ 75' AEC LINE
I _ -4 ' t G►-a v e I
NOW OR FORMERLY 0 I 14 owl,e, d. briv<2..
WEBR
D.B. 1648E P. 680 N I pox-6D� ��I
cv/vnve ,
O EIP D er..k.s
`1I 1, ' ONSLOW COUNTY FIRM INDICATES THE ENTIRE
Q i.,g�`�it.s. 1' - PROPERTY LIES IN FLOOD ZONE "C", HOWEVER IT
��/%,G = '��.`� N IS MY OPINION FLOOD ZONE 'A(8)" & "B" LIE
�~ ' 't WITHIN THE 75' AEC ADJACENT TO FULLARD
6 ..N N CREEK.
o �• .
T-I . y,
Uj ,,,,errto
r- / !',3•P I
TRACT TWO w -col , a NOW OR FORMERLY
23,116 SQ. FT. • In +
0.531 ACRES oo °I 41: z MONTGOMERY
•r ` _ D.B. 1024, P. 190
Ino • 50' M.B.L. •
EIP S84'39'08"W EIP S84'40'38"W EIP / EIR N84'44'54"E EIP
87.78' 76.00' N84'41'15"E 76.041 • 383.45'
S85'24'49"W C/L ASPHALT / N84'51'46"E N84'50'33"E N87'34'17"E
EPK 76.10' PK 99.44' EPK 830.59'
IN CENTER R F 550.14' EPK
CUL-DE-SAC 505.07'27"E l---
N.C.S.R. 1519 — ENNETT LANE so5.15'29"E
24.76' 50' R/W (ASPHALT — PUBLIC) 24.99'
LEGEND
REFERENCFC ECM = EXISTING CONCRETE MONUMENT (FOUND)
EIP - EXISTING IRON PIPE (FOUND)
D.B. 1024, P. 190 EIR = EXISTING IRON ROD (FOUND)
D.B. 1648, P. 680 EMN - EXISTING MAGNETIC NAIL (FOUND)
D.B. 1713, P. 111 EPK = EXISTING PARKER-KALON NAIL (FOUND)
F_ M.B. 34, P. 50 ERRS = EXISTING RAILROAD SPIKE (FOUND)
1...1 SCM = SET CONCRETE MONUMENT (CONTROL CORNER)
SIP = SET IRON PIPE
E THIS IS TO CERTIFY THAT THE SUBJECT PROPERTY -- SIR = SET IRON ROD
, IS LOCATED IN FLOOD ZONE C" WHICH • SMN = SET MAGNETIC NAIL (CONTROL CORNER)
ni IS NOT A SPECIAL FLOOD HAZARD AREA AS SPK - SET PARKER-KALON NAIL (CONTROL CORNER)
R• DETERMINED BY THE DEPARTMENT OF HOUSING AND R/W = RIGHT OF WAY
URBAN DEVELOPMENT. COMMUNITY PANEL NUMBER c. = CENTERLINE
_-- f7034O/0470 D NOVFM_P. I3 4._1q .- —_—_.-___ ._ENNETT LANE --MAL=-MINIMUM-BUILDING-LINE -- —
.—.
PROJECT HUMBER
BOUNDARY SURVEY FOR
-! I, CHARLES FRANCIS RIGGS , PROFESSIONAL LAND 01-06-12 .
SURVEYOR, DO HEREBY CERTIFY THAT I HAVE .
SURVEYED THE PROPERTY AS SHOWN HEREON IN JEFFREY S. HOLLAND
O ArtsnDI1AA7l•C WITL, TLC CTAAIIIADIIC /1C DDAr•TII^C ..,Ale: •

-
- - -
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CERTIFIED MAIL RECEIPT
(Domestic Mail Only;No Insurance Coverage Provided)
r Article Sent To:
a
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(Endorsement Required) SO
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• Total Postage 8 Fees $ J i V
✓ N (Please Pont !early (ofie co leted by mailer) y�{'���
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✓ .1104Mf Hit 41l21►J�
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CERTIFIED MAIL RECEIPT
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L-_-_Ai ELL{t\I 1k)-Gbek_ 4...) „v.,
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(01lW Ik:t AOS
(\cLTIt topS1 JL &ALA , 46Q, 244(400

Locality Permit Number
GENERAL INFORMATION
LAND OWNER
Name
II C -
-� e-�-� h
Address 6' f/ 6 16
City IV o r+A Yo p 50-j I 3 eo-c). State /\/G Zip g glPhone 9/a 3,g 33
AUTHORIZED AGENT GG// 336 '7/ 7
Name
Address
City State Zip �1 Phone
LOCATION OF PROJECT S8 Enhe ' Lh i Sheod-, e�� �J.� -I846 a
(If not oceanfront,is waterbody natural or manmade?) Va-" (_1~GL(
DESCRIPTION OFPROJECT S n � � Fa >T:1) . 0we/) ) 3 o\ kl 1—k ` Dbe-k-
t,U l G.�JI k24 )_/4 f) f oc rtowsc) — —
AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
(To be filled in by the Local Permit Officer prior to completing application.)
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
PROPOSED USE
Residential - Commerical/Industrial Other
SQUARE FOOTAGE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR
BUILT-UPON SURFACES (such as driveways, etc.) within 75 feet of the estuarine shoreline, or 575 feet of .
ORW shoreline, or 30 feet of the public trust shoreline. //5 00
SQUARE FOOTAGE OF TOTAL FLOOR AREA OF BUILDING 2-1* 00
SQUARE FOOTAGE OF SITE a a1 S 0
OTHER PERMITS MAY BE REQUIRED: Zoning, Drinking Water Well, Septic Tank
(or other sanitary waste treatment system),
The activity you are planning may require Burning, Electrical, Plumbing, Heating and
permits other than the CAMA minor Air Conditioning, Insulation and Energy
development permit. As a service we have Conservation, FIA Certification, Sand Dune,
compiled a listing of the kinds of permits that Sediment Control, Subdivision Approval,
might be required. We suggest you check Mobile Home Park Approval, Highway
over the list with your LPO to determine if Connection, and others.
any of these apply to your project.

APPLICATION FOR
„--)7x,A
7f joi),
0 CAMA
-, ( MINOR
5s
r I DEVELOPMENT
E1 i -.4......
ii
PERMIT
., , ,
In 1974,the North Carolina General Assembly passed
the Coastal Area Management Act and set the stage for
guiding development in the fragile and productive areas
which border the state's sounds and oceanfront. Along
4 °* with requiring special care by those who build and
I develop,the General Assembly directed the Coastal
Resources Commission (CRC) to implement clear regula-
tions which minimize the burden on the applicant.
IPlati r eg 1140. This application for a minor development permit under
CAMA is part of the Commission's effort to meet the
• k spirit and intent of the General Assembly. It has been
' designed to be straightforward and require no more
time or effort necessary from the applicant. Please go
over this folder with the Local Permit Officer(LPO) for
the locality in which you plan topt
build to be certain that
you understand what information he or she needs.
Under CAMA regulations,the minor permit is to be
'„ issued within 25 days once a complete application is in
hand. Often less time is needed if the project is simple.
The process generally takes about 18 days. You can
I ►+rr speed the approval process by making certain that your
ti4�► , 1.4 two . " application is complete and signed, that your drawing
meets the specifications given inside and that your
application fee is attached.
Ai
4 $ Other permits are sometimes required for development
O , $0 in the coastal area. While these are not CAMA-related,
# .,, ,,..r. we urge you to check with the Local Permit Officer to
determine which of these you may need. A listing is
included on page 2 of this folder.
4 We appreciate your cooperation with the North
..--
a, Carolina Coastal Management Program and your
40" willingness to build in a way which protects the
84 ;1 �. . resources of our beautiful and productive coast.
Coastal Resources Commission
Division of Coastal Management
.

STATEMENT OF OWNERSHIP
[, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in
an AEC or a person authorized to act as an agent for purposes of applying for a CAMA minor development
permit, certify that the person listed as landowner on this application has a significant interest in the real
property described therein. This interest can be described as: (check one)
an owner or record title, Title is vested in e r Q./ Sv 11�.h , see Deed Book /7/ 'j ,
page //) in the (j h 5 )o w County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County.
if other interest, such as written contact or lease, explain below or use a separate sheet and attach to this
application.
IOTIFICATION OF ADJACENT PROPERTY OWNERS
furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I
lave given ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for
CAMA permit.
(Name) (Address)
1) 13.I? rt) oh±dome}-Y ,z596 RIA.h kcQ .) Pe-thce, &eovge)U1t , 2.3a
2) ti ke l y h (,ue b er l 1 a Lt- Yh (A -41) G. 0r, ) 3- O el A)C, S ) 1 -
3)
4)
=0R DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
acknowledge that the land owner is aware that the proposed development is planned for an area which may
)e susceptible to erosion and/or flooding. I acknowledge that the local permit officer has explained to me the
'articular hazard problems associated with this lot. This explanation was accompanied by recommendations
'oncerning stabilization and floodproofing techniques.
PERMISSION TO ENTER ON LAND
furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer
Ind his agents to enter on the aforementioned lands in connection with evaluating information related to this
)ermit application.
['his application includes: general information (this form), a site drawing as described on the back of this application,
he ownership statement, the AEC hazard notice where necessary, a check for$100.00 made payable to the locality,
Ind any information as may be provided orally by the applicant. The details of the application as described by these
sources are incorporated without reference in any permit which may be issued. Deviation from these details will
:onstitute a violation of any permit. Any person developing in an AEC without permit is subject to civil, criminal
Ind administrative action.
Phis the / — day of 1-e-1) a-t"l ,20 0 .
17_iv
Land o or" 'e son authorized to act as his agent
for purposes of filing a CAMA permit application.

SITE DRAWING/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA minor develop-
ment permit. The drawing may be simple and not necessarily to scale. The Local Permit Officer will help you,
if requested.
PHYSICAL DIMENSIONS
label roads
label highways right of ways
label local setback lines
label any and all structures and driveways currently existing on property
PHYSICAL CHARACTERISTICS
draw and label mean high water mark
draw location of on-site wastewater system
If you will be working in the ocean hazard area:
draw and label dune ridges (note height)
draw and label toe of dune
identify and locate first line of stable vegetation
draw and label setback line under CAMA
draw and label topographical features(optional)
If you will be working in an estuarine shoreline area:
draw and label landward limit of AEC
describe terrain (slope)
DEVELOPMENT PLANS
draw and label areas that will be disturbed
if a house is to be placed on lot,describe location of house
note size of piling and depth to be placed in ground
draw and label all areas to be paved or graveled
describe composition of surface
note and list fully all trees and vegetation to be removed or relocated
show landscaping
NOTE TO APPLICANT
Have you:
*completed all blanks and/or indicated if not applicable?
*notified and listed adjacent property owners?
*included your site drawing?
*signed both application and statement of ownership?
*enclosed the$100.00 fee?
*completed an AEC Hazard Notice, if necessary?
FOR STAFF USE
Site Notice Posted Final Inspection Fee Received
Site Inspections
Date of Action: Issued Exempted Denied Appeal Deadline(20 days)

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