87988_Pamlico Plantation_20230117

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,�a4°``°4'k ct.❑CAMA El DREDGE & FILL ��5 No 87988 A ''i3 C D
GENERAL PERMIT �p -�2Oco7 Previous permit itl-
J
Date previous permit issued j /q
n New ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the Statea of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I5A NCAC C_J ki r Z - ❑Rules attached. n General Permit Rules available at the following link:wwwdeq.nc.gov/CAMArules
Applicant Name PO'Y'-',\ C r, r VA i 1 ',. Authorized Agent
Add Addren IS lj ' ,C, I tA b 1 QL c— f I rr(r"' Project Location(County): c:I t-4\-A
V J("City S j')),• t�4" ��State /N C ZIP ` 6-'1 Street Address/State Road/Lot#(s)
Phone#(7z'Z (I( 7)- � +; a5 r.
- ! i, II--
Email k;': `;-4-\- 0,N. . -',' Subdivision ri-:iY7•1 l ! • I- f. -, . .r_
City ZIP 4 GSM I
Affected ❑CW ❑EW ❑PTA ❑ES ❑PTS Adj.Wtr.Body man/unk)
AEC(s): n OEA n'HA ❑UW ❑SPIMA PWS Closest Maj.Wtr.Body \1 r o
ORW:yes/no PNA:yes/no N
Type of Project/Activity -4-,`,-4 / / i / . -,.� / I i 4, .) < /J P S
1 (Scale:"/"- i�,r
Shoreline Length # )6�'(f
i
Access Length I _ . .. -- — ,-", (
r I �_ — k ` ...
Pier(dock)length ( I . - -L,. s f ' S
Fixed Platform(s) /I I
7
Is A
Floating Platform(s)
---- I •
i u,C1
Finger pier(s) _ J �, _ y0
\Total Platform area + r 'r 111117—
Groin length/# "'.. « C ' N` { `
Bulkhead/Riprap length /� ,(\`• f I a-..{, p
Avg distance offshore ;,.) ! -_, —(-----�_. f
Breakwater/Sill r \``) _- -' L e ` I ,` 111I,
Max distance/length c.:' J ��' j
Basin,channel ' - �+ 1 E I , I I {
_._.
r—
Cubic yards '9Q �i' 41�.--r__' 0. "K
'iy, _ _. I ig i
Boat ramp E�� Q.�
Boathouse/Boatlift r. '>‘ i 3 ' i `t! e • f iI r r' }
Beach Bulldozing 'jig a ' "7-
Other .
• j \- I
SAV observed: yes no R -_ .lf, i'5 i-� �� G� Dc G.-1-,.,., ,.,—.,,a)
Moratorium: n/a yes no
Site Photos: yes no ------j - i
1
Riparian Waiver Attached: yes no I I
A building permit/zoning permit may be required by: '
n
Permit Conditions TAR/PAM/NEUSE/BUFFER(circle one)
❑See note on back regarding River Basin rules
114)tie p ekp of140144— etzb -(( ~ El 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) 1_)_S
K.AQ-t \ ',3 i A 2 c,,A ,...} ;,A 1 k,k 11
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
. �-1
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:
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

RbY COOPER
stc°sernor
r
MICHAEL S. REGAN
secretary
Coastal Management • B RAX T O N DAVIS
ENMtQQt* ItAL QUALITY Dbrc-
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 15A NCAC 02B.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) perrnit 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. •
1. 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.
z. 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 'ect site conditions: ZLIA � � Mat c-te IQ 4/ ,
1,0, '" Oc few / rG -
By your signature below you agree to be held responsible for meeting all of the conditions listed above a d verify
that
all information provided is complete and accurate.
Y
Agen Applicant Printed Name prryitp. Permit 0 cer's Signature
at.vw / 7 - -51G-7 - AO•23
r Applica g atu Issue Date
CAMA GENERAL PERMIT#: S-4 q
State of North Carortna I Environmental Quality I Coastal Management
Washington Office!443 Washington Square Mall Washington.NC 27889!252-946-6481
Wilmington Office 1 127 Cardinal Drive Ext.Wilmington,NC 28405-3845!410-7%-Th5
Morehead City Office'400 Commerce Avenue Morehead City.NC 2855? 1252-808-2808

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Pamlico Plantation Property Owners Associations
(Name of Property Owner)
property located at 150 Clubhouse Circle
(Address, Lot, Block, Road, etc.)
on. Broad Creek , in Washington , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
X I have,no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
The installation of boat lifts in existing wet slips on Dock A, Dock B and Dock C of the Marina
owned by Pamlico Plantation Property Owners Association (PPPOA)without any restriction as
to the number, the specific type or the manufacturer of the boat lift as such boat slip lifts are
required, requested and needed, but subject to the approval'of the Marina Committee and the.
PPPOA Board of Directors, given in accordance with the covenants, By-Laws and rules of the
PPPOA.
WAIVER SECTION
I understand that a`pier,.dock, mooring pilings, breakwater,boathouse, lift, or groin 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.
X I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
'fr`7 QA4/11v1,,kititut To p
Signature Signature olt l3 am,.
S GPA
Pamlico Plantation POA Townhome Owners-As ociation
Print or Type ,Name Print or Type Name
150 Clubhouse Circle 126 Forecastle Court
Mailing Address Mailing Address
Washington. NC 27889. _ Washington. NC 27889
City/State/Zip City/State/Zip
252=946-2390 252-946-2390
Telephone Number Telephone Number
Date Date
(Revised 6/1812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Pamlico Plantation Prooertv'Owners Associations
(Name of Property Owner)
• property located at 150 Clubhouse Circle
(Address, Lot, Block, Road, etc.)
on Broad Creek , in Washington , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below,the development proposed at the above
location.
Y I.have nb objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
The installation of boat.lifts in existing wet slips on Dock A and Dock B of'the,.Marina.owned by
Pamlico Plantation Property Owners Association (PPPOA)without any restriction as to the
number, the specific type or the manufacturer of the boat lift as,such boat slip lifts are required,
requested and needed, but subject to the approval of the Marina Comniittee.and'the.PPPOA
Board of Directors, given in accordance with the covenants, By-Laws and rules of the PPPOA.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 151-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.
(Prope Owner information) (Adjacent Property Owner Information)
Of tkr-A7
xg, nat 'e Signature LavOIIVv Lyh5,V '5MciNtlM • relist2:-::5 t'J
Print or Type Name Print or Type Name
1 GJi c. ..Achts 'ZM& ?-lib 5rAt Na RADA L -i)'
s
'lifiy/'linog Address Mailing Address
IN
City/Stateezgo City/State/Zip
IS",. 'MMI,t., 15a Q' 919-618-1367 _ _
Telephone Number Telephone Number
0 vY \O -vOlr'/ -
;alt 'i Dtrla• .
(Revised 6/182012)

Pamlico Plantation'Rules and Regulations Manual Procedure Number:R&R 30.8.4
I _
riae: Boat Lift Application Date of Issue: 18 July 2019
Name D4AiMy vfl t}yo Date it/V6-7 2' /
Address 34 PPDbt.e Wheel aide Atietc LotITH 1 2✓ '1/7W
Telephone (H) (C) `'704 1/3 '7D91 (W)
Slip Number to be Modified Slip Size
Boat Size.(LOA x Beam) of�f tt k ' tl
Contractor Installing Boat Lift: A- UJ4 — Phone Number: Sa 540- 8Q 3'(
Electrician Installing,Boat Lift: Ottsr QIveek Phone Number:
Requests for placement of boat lifts in the marina will be considered for permanent lifts requiring
additions or modifications to the marina infrastructure, i.e. pilings and electrical, and for floating
lifts that do not require,modifications. Permanent boat lift requests will be considered for docks
B and the inside of A only, located next to existing lifts if at all possible., It is the applicant's
responsibility to obtain a slip assignment before submitting this request. The Marina Committee
will assist the applicant in obtaining a suitable slip assignment. Floating lifts that comply with
C.) boat length requirements and require no permanent modifications are not restricted to Docks A
and B.
The following guidelines:must be complied with in order to receive Board of Directors' approval:
1. The property Owner, hereafter referred to as the applicant, seeking to place a boat lift in
their assigned slip shall submit all application documents, lift plans, manufacturing
brochures and pertinent information to the Marina Committee before-approval will be
considered.
—2..The applicant will obtain all required CAMA permits and furnish the Marina Committee
copies of the approved permits prior to any construction. The PPPOA will provide a letter
to the assignee of the slip stating that the assignee is appointed to act as the PPPOA's.
agent id reque"stingthe permit.
3. The applicant shall comply with all;the rules and regulations of the marina, including the
submission of a Boat Identification Form and a current liability insurance declaration
page with this application.
4. Any boat on the installed lift should be totally within the slip so that no part of the boat or
its motor protrudes into the fairway.
5. If the boat lift must be removed to repair or replace the pilings,finger piers, or docks,
removal will be made in a timely manner at the expense of the boat lift owner.
•
Pagel of4
•

Pamlico Plantation Rules and Regulations Manual ProcedureNmnber: R&R30:8.4
True: Boat Lift Application Date of issue: 181uly 2019
By completing and signing this application, the undersigned agrees to comply with the Marina
Rules and with the guidelines and specifications for installing a boat lift.
Signature: 6 ✓` sr_ Date: lO/ �f� %
Print Name: `-bA n/lf i----1 inii-yQ
Received by the Marina Committee: Date \I\t(-An-initials 0&i4i
Approved isapproved Date A-5\`ZZ Initials 1 1
Requests for further information and documentation: Date
Information requested:
H
Cif
ti
11
{
Page 3of4

Pamlico Plantation Rules and Regulations Manual Procedure Number:R&R 30.8.4
Title: Boat Lift,Application Date of Issue: August 15,2022
PAMLICO PLANTATION PROPERTY OWNERS ASSOCIATION
Notification to Slip Assignee(s)Adjacent to Proposed Boat Lift
This form should be provided to the adjacent slip assignees and a signed copy of this form should
be submitted foreach adjacent slip with the application to show notification has.occurred.
Name of lift applicant "Qdrwvi ,r 4onn,. N/10
Address IS Ll ?a.AAtt, IAA%4. `
Phone Number(s) —4 4.• 42l"3•
,
Slip to be modified �'3p1 djacent slip number b 4
t
Item 11 of the boat lift application requires the adjacent slip assignee s to be notified of the
proposed boat lift, and given an opportunity, if desired, to address the Marina Committee at its
next committee meeting, or to contact the chair of the Marina Committee if he/she has any
questions or concerns before the installation is approved.
As the assignee of a slip adjacent to a slip in which a boat lift is being proposed, you have an
opportunity to address the Marina Committee should you have any concerns regarding the
proposed installation. Whether you have concerns or not, please so indicate by signing this form
so the applicant can return it to the committee. If you do have concerns and wish to address the
committee in person, please notify the committee chair. The committee normally meets in the,
Clubhouse on the first Thursday of each month.
Adjacent Slip Assignee: it f (A/ 70.‘O Date /2 3 2_Z
signature)
(print name)
I wish to comment Yes Nof—
Page 4 of 4

Pamlico Plantation Rules and Regulations Manual Naeeme Mambo:R&R 30.8.4
•
Tea: Boat Lift Application Dame issue: August 15,2022
•
PAMLICO PLANTATION PROPERTY OWNERS ASSOCIATION
Notification to Slip Assignee(s)Adjacent to Proposed Boat Lift
' , This form should be provided to the adjacent slip assignees and a.signed copy of.this form should
be submitted for each adjacent slip with the application to show notification has occurred.
Name of lift applicant 1:lUin'MI r CAuAr& MAID
Address ( 3`t ' ?dJ'\t 0..J.4
Phone Number(s) • `tit •°l1
'Th
Slip to bo modified ID J A�djacent slip number b_
�
Item 11 of the boat lift application requires the adjacent slip assignee(s)to be notified of the
boat lift,and von an proposed g: opportunity,if desired,to address the Marina Committee at its
next committee meeting,or to contact the chair of the Marina Committee if he/she has any
questions or concerns before the installation is approved.
As the assignoo.of-a slip adjacent to a slip in which a boat lift is being proposed,you have an
•opportunity to address the Marina Committee should you have any.concarns regarding the
proposed installation.Whether you have concerns or not,please so indicate by signing this form
so the applicant can,rolum it to the committee.If you do have concerns and wish to address the. :-•. •..'
committee in person,please notify the committee ch ' . The comm' ec normally meets in the .•.•.•
Clubhouse on the first inlay of each month.
Adjacent Slip Assigned: Oate 1 �
nature)
. teresa Brooks
(print name)
.
1 wish to comment: Yes No �/
n Page 4 of 4
C$.,.e 0 "C.A. 2 vv.:4 S)

Pamlico Plantation Rules and Regulations Manual Procedure Number: R&R 30.8.4
7me: Boat Lift Application Date of Issue: August 15,2022 tX
Name f Lh ►� JW
rCi ct ,t ical le> Date 21 8122
Address t 0 Z C `r na Pa i'l Lot osr I TH
Phone number(s) 4304 - 89Z- 4910 (best number for contact)
Slip Number to be Modified It Y I
Boat Size (LOA and.Beam) 20
-
Contractor Installing Boat Lift: TV) — Phone Number:
Electrician Installing Boat Lift: P P-MECIV ep Phone Number:
t �C!{J2cu..ak ..•
Requests for placement of boat lifts in the marina will be considered for permanent lifts requiring
additions or modifications to the marina infrastructure, i.e. pilings and electrical, and for floating
lifts that do not require modifications. Permanent boat lift requests will be considered for dock B
and the inside of A only, located next to existing lifts if at all possible. It is the applicant's
responsibility to obtain a slip assignment before submitting this request.The Marina Committee
will assist the applicant in obtaining a suitable slip assignment. Floating lifts that comply with boat
length requirements and require no permanent modifications are not restricted to Docks A and B.
The following guidelines must be complied with in order to receive Board of Directors' approval:
1. The property owner, hereafter referred to as the applicant, seeking to place a boat lift in their
assigned slip shall submit all application documents, lift plans, manufacturing brochures and
pertinent information to the Marina Committee before approval will be considered.
2. The applicant will obtain all required CAMA permits and fumish;the Marina Committee copies
of the approved permits,prior to any construction.The PPPOA will provide a-letter to the
assignee of the slip stating that the-assignee is appointed to act as the PPPOA's agent in
requesting the permit.
3. The applicant shall comply with all the rules and regulations of the marina, including the
submission of a Boat Identification Form and a current liability insurance declaration page with
this application.
Page 1 of 4

i -
Pamlico Plantation Rules and Regulations Manual Procedure Number: R&R 30.8.4
The: Boat Lift Application Date of Issue: August 15,2022
to attend the meeting. If the application is approved by the Marina Committee it will be forwarded
to the PPPOA Board of Directors at its next monthly meeting for final approval.
If the Marina Committee does not approve this request, the applicant may appeal the decision to
the PPPOA Board at the next Board meeting.
My questions concerning these requirements and this procedure should be addressed to the
chair of the Marina Committee.
By completing and signing this application, the undersigned agrees to comply with the Marina
Rules and with the guidelines and specifications for installing a boat lift.
'V"vim-,�,r�,
Signature: y(� / t
Date: I2 8 Z2
Print Name: C)JV M g.a.I Ie y
Received by the Marina Committee: Date �1�`�ZZ-Initials
Approved Disapproved Date 15kZ3 Initials*IAA
Requests for further information and documentation: Date
Information requested:
i .
Page 3 of 4

Pamlico Plantation Rules and Regulations Manual Procedure Numbe;:R&R 30.8.4
ride: Boat Lift Application Date ofIssue: August 15,2022
PAMLICO PLANTATION PROPERTY OWNERS ASSOCIATION
Notification to Slip Assignee(s)Adjacent to Proposed Boat Lift
This form should be provided to the adjacent slip assignees and a signed copy of this form should
be submitted for each adjacent slip with the application top show notification has occurred.
Name of lift applicant Did ayhl,�e,. 5r ICME>J .ICAI ual KEG
r� Q
Address 1� Ck{�htt. �UPJ ) LOZS WAsiitg tck KEG 21.851
Phone Number(s) Soo— 8er2- 4118 504- lo'1 I'R6 4 I
Slip to,be modified B•4\ Adjacent slip number E' 43
U Item 11 of the boat lift application requires the adjacent slip assignee(s)to be notified of the
proposed boat lift, and given an opportunity, if desired,to address the Marina Committee at its
next committee meeting, or to contact the chair of the Marina Committee if he/she has any
questions or concerns before the installation is approved.
As the assignee of a slip adjacent to a slip in which a boat lift is being proposed, you have an
opportunity to address the Marina Committee should you have any concerns regarding the
proposed installation. Whether you have concerns or not, please so indicate by signing this form
so the applicant can return it to the committee. If you do have concerns and wish to address the
committee inperson, please notify the committee chair.The committee normally meets in the
Clubhouse on the first Thurs ay of each month.
Adjacent Slip Assignee: _ 77 (Airvr"L�t/C c°Date/n2/i 3/07a
at rti e
Se && Sa�,cr�. S4
(print name)
I wish to comment: Yes_ No
Page 4 of 4

. Pamlico Plantation Rules and Regulations Manual Procedure Number: R&R 30.8.4
toe: Boat Lift Application Date of Issue: August is,2022
I —
PAMLICO PLANTATION PROPERTY OWNERS ASSOCIATION
Notification to Slip Assignee(s)Adjacent to Proposed Boat Lift
This form should be provided to the adjacent slip assignees and a signed copy of this form should
be submitted for each adjacent slip with the application to show notification has occurred.
Name of lift applicant � �.111 WCF�//� e
Address 1 DZ ( A& /\ I.4.
Phone Number(s) t�l 'l r804— g92-4'9
8 `V
Slip to be modified L I Adjacent slip number w q
Item 11 of the boat lift application requires the adjacent slip assignee(s)to be notified of the
proposed boat lift, and given an opportunity, if desired, to address the Marina Committee at its
next committee meeting, or to contact the chair of the Marina Committee if he/she has any
questions or concerns before the installation is approved.
As the assignee of a slip adjacent to a slip in which a boat lift is being proposed, you have an
opportunity to address the Marina Committee should you have any concerns regarding the
proposed installation.Whether you have concerns or not, please so indicate by signing this form
so the applicant can return it to the committee. If you do have concerns and wish to address the
committee in person, please notify the committee chair. The committee normally meets in the
Clubhouse on the first Thursday of each month.
Adjacent Slip Assignee ✓ Date G 3
t�
(print name)u /
I wish to comment Yes No
Page 4 of 4

•
Pamlico Plantation Rules and Regulations Manual ProcedureNumber: R&R 30.8.4
rue: Boat Lift Application Date of Issue: August 15,2022
Name o. r..$ .1'Vo�ul.v-•Q J c V-LS Q 7l Date . 21, z02 3
Address \ O 9 C�P,ze v�\r o-r f-- Q_ Lot I Si !TH
Phone number(s) n— 911 '5 — go S5 (best number for contact) •
Slip Number to be Modified .8 " 3 b
Boat Size (LOA and Beam)
- L.0 A "3eaann
Contractor Installing Boat Lift: A - wait Phone Number: .25'2- 3
Electrician Installing Boat Lift: t J— ( L t L Phone Number:
Requests for placement of boat lifts in the marina will be considered for permanent lifts requiring
additions or modifications to the marina infrastructure, i.e. pilings and electrical, and for floating
lifts that do not require modifications. Permanent boat lift requests will be considered for dock B
and the inside of A only, located next to existing lifts if at all possible. It is the applicant's
responsibility to obtain a slip assignment before submitting this request. The Marina Committee
will assist the applicant in obtaining a suitable slip assignment. Floating lifts that comply with boat
length requirements and require no permanent modifications are not restricted to Docks A and B.
The following guidelines must be complied with in order to receive Board of Directors' approval:
1. The property owner, hereafter referred to as the applicant, seeking to place a boat lift in their
assigned slip shall submit all application documents, lift plans, manufacturing brochures and
pertinent information to the Marina Committee before approval will be considered.
2. The applicant will obtain all required CAMA permits and furnish the Marina Committee copies
of the approved permits prior to any construction.The PPPOA will provide a letter to the
assignee of the slip stating that the assignee is appointed to act as the PPPOA's agent in
requesting the permit.
3. The applicant shall comply with all the rules and regulations of the marina, including the
submission of a Boat Identification Form and a current liability insurance declaration page with
this application.
Page 1 of 4

p
Pamlico Plantation Rules and Regulations Manual Procedure Number: R&R 30.8.4
Title: Boat Lift Application Date of Issue: August 15,2022 `
4. My boat on the installed lift should be totally within the slip so that no part of the boat or its
motor protrudes into the fairway.
5. If the boat lift must be removed to repair or replace the pilings, finger piers, or docks, removal
will be made in a timely manner at the expense of the boat lift owner.
6. The applicant understands that the boat lift will not be insured by the marina and that liability
for damage caused by the lift or by the boat in the lift is the responsibility of the lift owner.
7. The lift is the property of the slip assignee and is to be conveyed with all rights and
responsibilities to future owners.The lift can be transferred to (a)a new owner of the
lot/townhome, (b) another PPPOA member and the slip will be reassigned to that member, or
(c)someone else and the lift and its associated pilings must be removed from the marina. If
the slip assignee sells his lot/townhome and is no longer a member of the PPPOA the
disposition of the lift must be settled before the sale is completed. If required, the responsibility
for the cost of removal of the lift lies with the seller of the property and must be carried out
prior to conveyance of ownership.
For lifts requiring pilings and other permanent modification of marina infrastructure:
Refer to Directions and Specifications for Applying for a Boat Lift for piling and electrical details.
' 8. All new pilings must be consistent with the piling height of the marina pilings where possible.
Newly installed pilings must be inside the existing pilings of the slip. No existing pilings can be
cut or modified for any reason.
9. No piling placement is to take place unless a Marina Committee member is present. It is the
responsibility of the applicant to coordinate the work with the Marina Committee representative
who must be given a minimum of notice of 48 hours.
10. Electrical connections for the lift must be made by a licensed electrician according to
specifications provided by the Marina Committee. Electrical work will be contracted by the
Marina Committee and costs will be charged to the lift owner.All electrical work is subject to
inspection and approval.
11.Adjacent slip assignees shall be notified of the proposed boat lift and given an opportunity to
either address the Marina Committee at the next committee meeting or contact the committee
chair if they have questions before the installation is approved. Copies of the signed attached
notification form shall be appended to the application.
The applicant must submit this request to the Marina Committee after ascertaining that the
applicant is able to meet all of the above requirements.The application will be considered by the
Marina Committee at its next regularly scheduled monthly meeting, and the applicant is welcome
Page 2 of 4

Pamlico Plantation Rules and Regulations Manual Procedure Number: R&R 30.8.4
rue: Boat Lift Application Date of Issue: August 15,2022
to attend the meeting. If the application is approved by the Marina Committee it will be forwarded
to the.PPPOA Board of Directors at its next monthly meeting for final approval.
If the Marina Committee does not approve this request, the applicant may appeal the decision to
the PPPOA Board at the next Board meeting.
Any questions concerning these requirements and this procedure should be addressed to the .
chair of the Marina Committee.
By completing and signing this application, the undersigned agrees to comply with the Marina
Rules and with
the
�guidelines
�and specifications for installing a boat lift.
Sig aturrS e: ` Cafr" ld tca"s Q's" Date: . 26 a023
Print Name: 1i ci—tiS ea hSo r1
ialA-'ri �u‘nnSon
Received by the Marina Committee: Date II*-2-3 Initials(W
an
Approved Disapproved Date �' l Initials
Requests for further information and documentation: Date
Information requested:
Page 3 of 4

. Pamlico Plantation.Rules and Regulations Manual Procedure Number: R&R 30.8.4
Tide: Boat Lift Application Date of Issue: August 15,2022
PAMLICO PLANTATION PROPERTY OWNERS ASSOCIATION
Notification to Slip Assignee(s)Adjacent to Proposed Boat Lift
This form should be provided to the adjacent slip assignees and a signed copy of this form should
be submitted for each adjacent slip with the application to show notification has occurred.
Name of lift applicant )-1C n. S d' T� 3 . .-.„s4_ ")\n,''So n
Address 1 O / G r e.e-vim, L La_�t_
Phone Number(s) �S Zx-� LI 5 — 5 O 5 7
Slip to be modified?" 35 Adjacent slip numbs - 3 ,
4 B - 3
Item 11 of the boat lift application requires the adjacent slip assignee(s)to be notified of the
proposed boat lift, and given an opportunity, if desired, to address the Marina Committee at its
next committee meeting, or to contact the chair of the Marina Committee if he/she has any
questions or concerns before the installation is approved.
As the assignee of a slip adjacent to a slip in which a boat lift is being proposed, you have an
opportunity to address the Marina Committee should you have any concerns regarding the
proposed installation. Whether you have concems or not, please so indicate by signing this form
so the applicant can return it to the committee. If you do have concerns and wish to address the
committee in person, please notify the committee chair. The committee normally meets in the
Clubhouse on the first Thursday of each month.
Adjacent Slip Assignee: N : �\s 'c Date 13 \• 3-A-•13
(signaturb)
(q^') Vic y \
(print name)I wish to comment: Yes No �//
Page 4 of 4

Pamlico Plantation Rules and Regulations Manual ProcedureNumber: R&R 30.8.4
Title: Boat Lift Application Date of Issue: August 15,2022
PAMLICO PLANTATION PROPERTY OWNERS ASSOCIATION
Notification to Slip Assignee(s)Adjacent to Proposed Boat Lift
This form should be provided to the adjacent slip assignees and a signed copy of this form should
be submitted for each adjacent slip with the application to show notification has occurred.
Name of lift applicant 1 1 c-aS 't tGkAlc.,ca. -30 V1v-t S
Address I 0 7 G )-e + ��
L.JrsV-�n51o.1 Y1C 27S`3'`T
Phone Number(s) 25 Z — `T 9,5 - FS O go
Slip to be modified S — 35 Adjacent slip number 33
€ `b - 37 )
Item 11 of the boat lift application requires the adjacent slip assignee(s) to be notitied of the
proposed boat lift, and given an opportunity, if desired, to address the Marina Committee at its
next committee meeting, or to contact the chair of the Marina Committee if he/she has any
questions or concerns before the installation is approved.
As the assignee of a slip adjacent to a slip in which a boat lift is being proposed, you have an
opportunity to address the Marina Committee should you have any concerns regarding the
proposed installation. Whether you have concerns or not, please so indicate by signing this form
so the applicant can return it to the committee. If you do have concerns and wish to address the
committee in person, please notify the committee chair. The committee normally meets in the
Clubhouse on the first Thursday of each month.
Adjacent Slip Assignee: Date /2 7/z$
(sig lure)
-Jerry Hor✓'c9vy-
5
(print name)
I wish to comment: Yes No
Page 4 of 4

Pamlico Plantation Rules and Regulations Manual Procedure Number:R&R 30.8.4
line: Boat Lift Application Date of Issue: August 15,2022
•
PAMLICO PLANTATION PROPERTY OWNERS ASSOCIATION
Notification to Slip Assignee(s)Adjacent to.Proposed Boat Lift
This form should be provided to the adjacent slip assignees and a signed copy of this form should
be submitted for each adjacent slip with the application to show notification has occurred.
Name of lift applicant 3 W 4. I EARroodAlts
Address LIDS `J7 r p
Phone Number(s) t� (0°7° o�" aq .—tC Z0c,
Slip to be modified - Adjacent slip number 13^ 5
Item 11 of the boat lift application requires the adjacent slip assignee(s)to be notified of the
proposed boat lift,and given an opportunity, if desired,to address the Marina Committee at its
next committee meeting,or to contact the chair of the Marina Committee if he/she has any
questions or concerns before the installation is approved.
As the assignee of a slip adjacent to a slip in which a boat lift is being proposed,you have an
opportunity to address the Marina Committee should you have any concerns regarding the
proposed installation.Whether you have concerns or not, please so indicate by signing this form
so the applicant can return it to the committee. If you do have concerns and wish to address the
committee in person,please notify the committee chair.The committee normally meets in the
Clubhouse on the first Thursday1r`�� of each month.
Adjacent Slip Assignee:�J' " --W" Sinn Date �%z7/2�Z�
r((signature) r F+t�5 T /k �t- S O i 1
(print name)
I wish to comment: Yes_ ' No V
Page 4 of 4

Pamlico Plantation Rules and Regulations Manual Procedure Number R&R 30.8.4
Tale: Boat Lift Application Date of Issue: August 15,2022
to attend the meeting. If the application is approved by the Marina Committee it will be forwarded
to the PPPOA Board of Directors at its next monthly meeting for final approval.
If the Marina Committee does not approve this request,the applicant may appeal the decision to
the PPPOA Board at the next Board meeting.
Any questions concerning these requirements and this procedure should be addressed to the
chair of the Marina Committee.
By completing and signing this application,the undersigned agrees to comply with the Marina
Rules and with the guidelines and specifications for installing a boat lift.
Signature: A/711 AA Date: S L.3
Print Name: 0-Y1 81./ cret1f 45
11
Received by the Marina Committee: Date ` % 31 I Z Initials 0 1
Approved 7 Disapproved_ Date A'A''9 Initials C13n1
Requests for further information and documentation: Date
Information requested:
Page 3 of 4 —