General Permits (771)

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CERTIFICATION OF EXEMPTION
Y_ FROM REQUIRING A CAMA PERMIT ra• le. t (C. 17,E
as authorized by the State of North Carolina, f^{ t `t+ <or Al
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name kt v - c' . (a. i'.,,
Addressy3 lJvo,lAufa 1,0rc
City (4 v 4.
Project Location (County, State Road, Water Body, etc.)
-J
State
Phone Number Q11- 3 i?s
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Zip 7F,51L
Type and Dimensions of Project r> -fir-, t..[ S' E,.,. Ma, ,C, ! •A S' c � F. �� ti • tt
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The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 15 NCAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA permit is
valid for 90 days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
SKETCH 4(,- rw,-7.f- (SCALE: )
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raarj�. Sb�Fril�r V f'� t`)�ui) nc1 �,1�rN% fJt„ AH /+/ rrC G(rC�t llsf;�rlt �i�r�%, !fit Ifu+! Alorlif l<
1•^...r Q�.tr.eli t/K�' � ��
Any person wno proceeas wnn a aeveiopmem wiinout ine con-
sent of a CAMA official under the mistaken assumption that the
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development.
The applicant certifies by signing this exemption that (1) the ap-
plicant has read and will abide by the conditions of this exemp-
tion, and (2) a written statement has been obtained from adjacent
landowners certifying that they have no objections to the
proposed work.
ijC-�04•(� }�7F-
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Applicant's signature I
n
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CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

Certified Mail Provides:
■ A mailing receipt
■ A unique identifier for your mailpiece
■ A signature upon delivery
■ A record of delivery kept by the Postal Service for two years
Important Reminders.,
■ Certified Mail may ONLY be combined with First -Class Mail or Priority Mail.
■ Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables, please consider Insured or Registered Mail.
■ For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPS postmark on your Certified Mail receipt is
required.
■ For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with the
endorsement "Restricted Delivery".
■ If a postmark on the Certified Mail receipt is desired, please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed, detach and affix label with postage and mail.
IMPORTANT. Save this receipt and present it when making an inquiry.
PS Form 3800, May 2000 (Rev'arsei 102595-99-M-2087

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Postage
Certified Fee
$J^
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Return Receipt Fee
Postmark
N �H
O
(Endorsement Required)
1%1
1:3
Restricted Delivery Fee
(Endorsement Required)
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171-
Total Postage &Fees
$ /
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Sent To
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- v►c�e rso h-__---
Street, Apt. No.; or PO Box No. - ----------------------------------
/a1 V i l lad CoA
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City, State, IP,4
Aaue lock IVC-
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UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
LISPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
6ul, Q -cc,v /r,"�
chAs0L11'fit �or f lV C o2gS/,6
:.w:.iZ"- �' 114. 4�:

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece
or on the front if space permits.
Article Addressed to:
Tebbe -AoJP- soh
/a 1 U(' l l'Age eo-o-'-t
M a ue loc ic; N C
S &5 3,L
2. Article Number (Copy from service label)
A. Raceiv by Please Print Clearly) B. ate of Delivery
6Y
C. Signature
X ❑ Agent
❑ Addressee
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
0 Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
PS Form 3811, JUIy 1999 Domestic Return Receipt 102595-00-M-0952

DFV
SJON OF
ASTAL
ADJACENT RIPARIAN PROPERTY OOyy�,E MANAGEMENT
NOTIFICATION/WAItiER FGRtii
Name of Individual applying for Permi,21
t:
Address of Property:—Z� L3—
(Lot or Street = Sirt.t or Road, Citv & County)
9
I hereby cc,-y that I own propeiy adjacent to the above reverenced grope..Lv. The individu
applying for this permit has described to me as shown on the attache✓ drawing the deve:oome:1ll
t
they are proposing. A descr-;pdon or drawing, wi
letter. th di: ,ensions. s ,ouid be Provided w: h this
i
I have no obzc ' _.
-� _ dons to this proposes. JUN Z 2001
If you have objections to what is being proposed, please wr,�e the DiYZsion of Coastal
�ilanagement, Hestrnn Plate II 151-B Hwv.
> , Morehead Cuv, A:C, 285J7 or call (25?1 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no obiection
it you have been notified by Cerr ed Mail.
WAI -ER SECTION
I'Understand that a pier, dock, mooring
Pilings, brea�,�ate- boat house li<< or sandba=s mu_t be
se: back a minimum distance of 15' iiom my area of i=a, access unless '
W.En to waive the se:back, you must initial the anprot, ;a:e bunk below., waived by ou
I do wish to waive the 1 5' setback reeuir ement
I do not wish to waive the 15' setback rec'ire:ne:-it.
S7 a- I&
ian Lure
Date
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Pn1 Nam
Telephone Number With Area Code

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POyUELL SUPWEY�,,�G
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Carteret County �T
Department of Planning
Courthouse Square U
Beaufort, NC 28516-1898 �0
[phone] Office [phone] Fax �n
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to: 'e U i V-)
property located at: 113 \/l/ y vi h , `J P ", '6r t
near (water body): u S S e r -c- (�
in (county): 0 -,�s V� +,e r e-t
The applicant described to me as shown below, the development he/she is proposing in
that location and:
1 have no objection to this proposal:
I o s
Description and/or drawing of proposed development:
Signature.R"_
Name: Cupt-C►S -L
Phone Number: <O 3 - S I? 3 - O + 4i
Date: �� 3 2 0 0

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