79830_Scott Tabor_20210712

QCAMA/ E DREDGE & FILL .-1.D44 (,ggQQ N9 79830 A ``� C D
' W GEN ERAL PERMIT Previous permit#
) ❑iNew ❑Modification El Reissue ❑Partial Reissue Date previous permit issued /✓f
C
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 7/-/ / C)
7 /// co Rules attached.
Applicant Name -�f / Lt- Project Location: County �..
Address /5�,/ 2._E L.--,-• 4/ Street Address/State Road/Lot#(s) // 2. �,,_K 4—__
C
City yvc.-u.) 77;�.c-.-ti State At ZIP S G> ,(. , r° '
Phone# ( ) ->?'V E-Mail i /'4'1- L/ ii,a ,/ /;-`'. Subdivision
Authorized Agent City ZIP 2-`3 C S C
❑CW IgEW Ll'PTA ❑ES ❑PTS Phone# ( •') `/ 77/2 River Basin ,•`..-Le"-- e._
Affected ❑OEA ❑HHF ❑IH ❑UBA ❑N/A C jL
AEC(s): Adj.Wtr. Body c.--X , ,kriat Anan /unkn)
❑ PWS:
ORW: yes I no PNA / o ._ - " ` , "`Closest Maj.Wtr. Body
Type of Project/Activity p%.so - L ^'4 /- / - / I/ .
/ L (Scale: /,'r )
Pier(dock)length 4c
Illi I ( k
Fixed Platform(s) .V/ C .Ci i `� ji I
Floating Platform(s) / � i 1 , d
\
4 i
Finger pier(s) i
Groin length
number i I .1.
Bulkhead/Riprap length i __ 4 1_ -. .___._ Y _- --
avg distance offshore i.► _ ,
5,1
max distance offshore • 3 • (ley— �' 1
Basin,channel I f� r G 'i , Ir')IC
1 1 ,�`
cubic yards I 1 �U
Boat ramp 1 i I lI j
j
Boathouse/Boatlift /3u/ ' ' -
: 1:::
ill — i ij1 ! 1 1 4 .
, 1 - , , , .
, , , , 0 - eir,Th-t- ! 1 , ;
_f/
SAV: not sure yes no — — f } --{-t. i_..... j "s
Moratorium: n/a yes no f 4R
Photos: es no 1 I _ '
Waiver Attached: yes 6io �`.T i , I
A building permit may b required by: �ti,I �I L.`--C ' \itSee note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) ® �.,/- f�
Notes/Special Conditions /b J� ( c-,/c --, �>` ' "- 'r'e7t 3
R00.r1 i �c.ok l- l 1 \V r <,, volt I\CI rU.
Agent or Applicant Printed(Jame PermitOfficer Prin Name
SliA)4A4k- )'1 . "` ,mot.. 'c
Signature **Please read compliance statement on back of permit** Signature
,l /°7- �617(/ /2 26) 2-/ - /l v / Z, 7G Z_ 1
Application Fee(s) Check# Issuing Date Expiration Date

r
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:
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(910-796-7215)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. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 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

I OF
ECAMA/ E DREDGE & FILL "=D 1py900 No 79830 A B C D
GENERAL PERMIT Previous permit#
>�—= ,❑New .Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued ,
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 7/-1 .
IIJ Rules attached.
i
Applicant Name Project Location: County '
Address t 1 Street Address/State Road/Lot#(s) / ! ,
City / e ,d ' 4 -. • .. State ZIP
Phone# ( ) E-Mail Subdivision
Authorized Agent City ZIP
Affected ❑CW ❑EW C PTA ElES ❑PTS Phone# ( ) River Basin -
111 AEC(s): oEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body (nat /man /unkn)
❑ PWS:
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body
Type of Project/Activity
(Scale: )
Pier(dock)length '
t
Fixed Platform(s) i L t
1 1 0- r (,_
Floating Platform(s) \r/' ( ,'
Finer pier(s) I
Groin length I _ I
number G r _ .. ..... -
Bulkhead/Riprap length ..-...____.__. -.._ __ ._..__---_ T__t __
avg distance offshore !/ + I �J� - f
max distance offshore J II _ �._ „,Cr ` !, -
Basin,channel ,_ 1 I i - } f ' 4. r
• t'
I t. ' ii
cubic yards I /'
t 1
Boat ramp i
a , I
Boathouse/Boatlift 1 T '"' I
i. ....I _....__ .- --�-�- --—' I ............. _.-. _ ._ ----...__
Beach Bulldozing = " _- I _.� - _-._-----
Other i
I
Shoreline Length 1 ,
L
es noIy , 1ch
j
Moratorium: n/a yes r ,I I ' 4 >` 4
A,T�.
Photos: yes no ) i t k __ q a
Waiver Attached: yes no
- I
A building permit may be required by: j 0 See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
Notes/Special Conditions �' '' I
Agent or Applicant P 'nted Name Permit Officer' Printed Name %-
i'
Signature **Please read compliance statement on back of permit** Signature
i' / / r ? i AL, L 11_ -
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:
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 (252-946-648I) 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. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-390 I Fax: 9 I 0-395-3964
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

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: Scott & Sherry Tabor
Address of Property:
172 Buxton Avenue Merritt, NC 28556
(Lot or Street#, Street or Road, City&County)
Agent's Name#: Scott Tabor Mailing Address: 1564 Lee Landing Rd
Agent's phone#: [phone] New Bern, NC. 28560
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.
1/ I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed,you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at http://www.nccoastalmanagement.net/web/cm/staff-listing or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must
be set back a minimum distance of 15' from my area of riparian access 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' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Riparian Property Owner Information)
")CZA- t----e j4/'
Signature Signature
�
Scott & Sherry Tabor Pa_Lt. i N 1.
a_,sd�
Print or Type Name Print or Type Name
1564 Lee Landing Rd °,1 s m t I)
Mailing Address Mailing Address 1 '
New Bern, NC. 28560 N4 L
City/State/Zip City/State/Zip
252-634-7712 [e-mail] `if � /1
Telephone Number/Email Address Telephone Number/Email Address
-2 7 •- 2� 2 6,_ , , A
Date Date
(Revised Aug. 2014)

Receipts for
Certified Mail
5 -2 7-26 2 1 (Staple Here)
Date 11 r
If;Am S E95/ i ru5 PRu),'Ne FASo-rt/
Adjacent Propeaawtle; 1 ; � re5
Mailing Address
City, State,Zip Code 2 7 S 3 LA
Dear Adjacent Property: CC t
This letter is to inform you that I, 5COR hril rear have applied for a CAMA Minor
Property Ownel•
,11 P,4-m1;co
u Permit on my property at 1-7 2 ,c�,,� •}p ru I*u , ef-r' H, IU•C ,in COUNTY
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s)as notification of my proposed project. No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project,please
contact me at 952 6 311` -7 7 ) Z ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program,you may submit
them to:
LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
CITY,STATE,ZIP CODE
Sincerely,
Property Owner
i 56M e_ LA7.,d;N Rai,
Mailing Address
New B•er-r) 1 N• C, s2-g .ct o
City, State,Zip Code

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
A
I hereby certi that I own property adjacent to /4(././(4.-,:g ,
(Name(f of Property Owner)
property located at / `� c / /L-C^�
7 �Address, Lot, Block, Road,etc.)
on 1�2�-Ley' f C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s),the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Signature
Iaa-k.,1 /Ll)2_ 13, a5biy
Print or Type Name
// 923,6" 3a10-
Telephone Number
c- I
Date

CERTIFICATE OF SURVEY AND ACCURACY
SITE .4\\ I, WIL NAM E. MATTHEWS, CERTIFY THAT THIS MAP WAS
VV// DRAWN UNDER MY DIRECTION AND SUPERVISION
FROM AN ACTUAL SURVEY OF LAND;THAT THE ERROR
43 N OF CLOSURE AS CALCULATED BY IATRUDES AND DE-
PARTURES IS 1.10.000+:THAT THE BOUNDARIES
OIRUD NOT SURVEYED ARE SHOWN AS BROKEN UNES;
CREEK WETNESS MY HAND AND SEAL THIS
Pc DAY OF WY ALN , 2005.
VICINITY MAP
PROFESSIONAL D S R
L-1282
� ``,pl'Juili#1, REGISTRATION NUMBER
� qs
43..o S/0 14? S BOOK 443 PAGE 148
s * a SEAL to ti
r- r" L-1282 ¢ S LOCATED IN FLOOD ZONE AE
r yi` ? BASE FLOOD ELEVATION 7.0'
K v� ' COMM. PANEL /: 3720-740800-J
BUXTON ORES iy` F SUR ;' •
.� EFFECTIVE DATE: JULY 2, 2004
B aA �-N�� ', WARD 44%'' FOR COVERING DEEDS SEE DEED BOOK
• 215 PAGE 934. AND DEED BOOK 218
9 �/� PAGE 297. PAMUCO CO., N.C. REGISTRY.
60.0°' '
•
/ ,-� NV' � � 56534 te, �
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ssP zs �9.�
46.00' ' 363 18E WILLIAM S. EASON TRUST
N7'21'32"W fa,T 4" DB 317, PC. 526
Vitt)yL \V'''.,;5'6'
�p WA 1\ GCH. 0 0,53 acres
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JAMES MORRIS ETAL• 4r r?tr • A00 A�1 AvEL
DB 215, PG. 639 t� �' �• WMO 5722T 0° ' G`'
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0N '.iOO r SON A.EN
512Z�,p0 Bux
\ OP
NORTH CAROLINA
PAMLICO COUNTY
LEGEND: y
SIP = SET IRON PIPE Q I �'Lif4 1,15.?A[X� REVIEW OFFICER OF PAMLICO COUNTY,
LIP - EXISTING IRON PIPE CERT! THAT THE MAP OR PLAT TO WHICH THIS CERTIFICATION IS
R/W- RIGHT-OF-WAY AFFIXED MEETS ALL STATUTORY REQUIREMENTS FOR RECORDING.
WM = WATER METER
1A7 1��.gd
R EW OFFICER
DATE:3-a4-OS
=SURVEY FOR—
CHARLE,S' T. BRAN/CS'
TYENTY P. BALL14RD THIS PLAT IS OF A PARCEL OR PARCELS OF LAD, AN EXISTING
NO. 2 TWNSP. PAMLICO COUNTY, N.C. MATTHEWS SURVEYING PLLC
SURVEY BY: MATTHEWS SURVEYING PLLC. Professional Land Surveyors
FEBRUARY 23, 2005 SCALE: 1"= 40'
William E. Matthews R.L.S. L-1282 �!
40 20 0 sox
�•_�— 1280 Wintergreen Rd. —
Cove City N.C. 28523
SCALE: 1'= 40'
Phone ( 52)837-7070 _
Fax [phone]
Book: 443 Page: 145 Seq:4

U.S. Postal Service`""
CERTIFIED MAIL° RECEIPT
_a Domestic Mail Only
Ltl For delivery information,visit our website at www.usps.com"`.
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Certlfi all ee L���
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0 ❑Adult Signature Required t4AY 2 7 202,
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PS Form 3800,April 2015 PSN 7530-02-000-9047 See Reverse for Instructions

Certified Mail service provides the following benefits:
•A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
•A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
•Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. LISPS®-postmarked Certified Mail receipt to the
•A record of delivery(including the recipient's retail associate.
signature)that is retained by the Postal Service'" -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
Important Reminders:' -Adult signature service,which requires the
•You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Mail®,First-Class Package Service®, available at retail).
or Priority Mail®service. -Adult signature restricted delivery service,which
•Certified Mail service is not available for requires the signee to be at least 21 years of age
international mail. and provides delivery to the addressee specified
•Insurance coverage is not available for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
certain Priority Mail items. LISPS postmark.If you would like a postmark on
•For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.
PS Form 3800,April 2015(Reverse)PSN 7530-02-000-9047

U.S. Postal Service"
CERTIFIED MAIL° RECEIPT
m Domestic Mail Only
0
ix) For delivery information,visit our website at www.usps.com".
rq
Certifie II Fep fj ru P ,•`Aru r
Cr $ (,( V Ll
0 Extra Services&Fees(check bar,add t appro )
0 Return Receipt(hardcopy) $
❑Return Receipt(electronic) $ Postm
0 ❑Certified Mail Restdcted Delivery $ rlr f`v ��Here
I= 0 Adult Signature Required $ `1. 2e
❑Adult Signature Restrict Delivery$
0 Postage )
,3 Total Postage and Fees
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0 Sent To Vp
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City,State,ZlP+46 ,�
Pr,Grate 3800,April 2015 PSN 7530-02-000-9047 See Reverse for In r

Certified Mail service provides the following benefits:
•A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail
•A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
•Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the
•A record of delivery(including the recipient's retail associate.
signature)that is retained by the Postal Service'" -Restricted delivery service,which provides
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent.
Important Reminders: -Adult signature service,which requires the
•You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Mail0,'First-Class Package Service0, available at retail).
or Priority Mail®service. -Adutt signature restricted delivery service,which
•Certified Mail service is not available for requires the signee to be at least 21 years of age
international mail. and provides delivery to the addressee specified
•Insurance coverage is not available for purchase by name,or to the addressee's authorized agent
with Certified Mail service.However,the purchase (not available at retail).
of Certified Mail service does not change the •To ensure that your Certified Mail receipt is
insurance coverage automatically included with accepted as legal proof of mailing,it should bear a
certain Priority Mail items. USPS postmark.If you would like a postmark on
•For an additional fee,and with a proper this Certified Mail receipt,please present your
endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for
the following services: postmarking.If you don't need a postmark on this
-Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion
of delivery(including the'recipient's signature). of this label,affix it to the mailpiece,apply
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardcopy return receipt,
complete PS Form 3811,Domestic Return
Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records.
3800,April 2015(Reverse)PSN 7530-02-000-9047
Jri

Vaughan, Kent D
From: scott tabor <[e-mail]>
Sent: Tuesday,July 13, 2021 9:25 AM
To: Vaughan, Kent D
Subject: [External] Fwd: CAMA Permit
CAUTION: External email. Do not click links or open attachments unless you verify.Send all suspicious email as an attachment to
Report Spam.
Forwarded message
From: Robbie Stallings <[e-mail]>
Date: Tue, Jul 13, 2021, 9:20 AM
Subject: CAMA Permit
To: [e-mail]<[e-mail]>
Hi Scott,
Per our conversation, I received via certified mail from CAMA your proposed drawing of your dock
and boat lift. I am fine with the design as proposed.
Best,
Robbie Stallings
Sent from my Verizon, Samsung Galaxy smartphone
1

ROY COOPER
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.
• Pre-project site conditions: —114'U'ry � ' 1}h 5om a t-eC S
By your signature below you agree to be held responsible for meeting all of the conditions listed a v and verify
that all inform on rovided is complete and accurate.
Agent or Applicant Printed Name P it O 'c s Signature
4,0)4) 7�/2 // Z/
Agent or Applicant Signature Issue Date
CAMA GENERAL PERMIT#: 19 '3O ?V
State of North Carolina I Environmental 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 1910-796-7215
Morehead City Office 1400 Commerce Avenue Morehead City,NC 28557 1252-808-2808