General Permits (843)

CERTIFICATION OF EXEMPTION
_Y FROM REQUIRING A LAMA PERMIT re,
as authorized by the State of North Carolina, 1. JGla 3lIIA
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.
5516q ( 1GrGj)
Applicant Name
Address WQ
City '! r State tyt Zip `hZ,54
Project Location (Fount , State Road Water Body, etc.) r E F 5.-.,1,.
mto
i nt !: , 4� i1 t&: Phone Number 5.? V* , 71/t 3
Type and Dimensions of Project K, , Pa ., c, i �, "• t, i i,f4 41e, me' ll, 40'1. i. P.
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 X1, f 5 (SCALE:
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Any person who proceeds with a development without the 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.
Applicant's signature
CAMA Official's signature
;u 1 c
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

I
G�nmiy,2,.
Coastal Properties
610 Atlantic Beach Causeway
PO Box 1089
Atlantic Beach, North Carolina 28512
Business [phone]
Fax [phone]
Toll Free [phone]
E-Mail [e-mail]
Mr. Ronald D. Becton
945 Temple Point Road
Havelock, N.C. 28532
I Ronald D. Becton authorize Carton and Elaine Patton to put the Cama Permit (rip -rap) in their
names.
Date:
—
Signature:
Ronald D. Becton
Each Office Is Independently Owned And Operated

Aug 17 01 04:26p C21 Coastal Properties 252-726-2867 p.3
ADJACE T RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify t I own property adjacent to (Name of Porperty Owner)
S s � z�s3z
property Irxated at 13o- !� Io
( ot, Block, Road, etc) l
in
N. C.
on - (W atcrbody) (Town and/or County)
He has described, to me sho%vn below, the development he is prl� nsing at that location,
xnd, I have no objections�to his proposal.
DESCRI
AND/OR DRAWING OF PROPOSED DEVELOPMENT
,e filled in by individual proposing development)
;, VA) Ne- C))(5r>
AoL( -�lJ,-}/ ail
qp b 7 r p r I/
f
Signature
Print or type name C,
Tele. Number
Datc! �� O

Rug 17 01 04:26p C21 Coastal Properties 252-726-2067
'08/15/2014 05:1B 609541000E Q.L,HaRKLEY PAGE 02
252-726-29177
p.2
P•I
"DACE T RIPAftlAN PROPERTY OWNER STATEWrNT
I bereby eptify t 1'" propem adjacent eo A 71� ^}- e d 9< A
(Name of Potporty OtN+er)
propert7 located a1 3O c D
( aloek, (load, etc)
on y
lin �_ N C,
(Town +armor Covnry)
"I ha deAtri 10 me aI lhown bt)ow, tha dtvokpment Hen pr�ofine at that location,
And, 1 have no ob)acti0u wa proposal.
DESCORTI N MIDIOR DRAWWO OF PROPOS» DEVELOPMENT
•o bt "Nd in by individual prope4s dmlopment)
c)f v -- cz n;A i 4 o cogs /►-qc_V
r- t- e p b o�t��• f/ oN
pro 941,11.