General Permits (888)

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CERTIFICATION OF E
FROM REQUIRING A CAMA PERMI
MAY 0 2001
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resourc a the Coastal Resourc s ommission
in an area of environmental concern pursuant to 15 NCAC Su TdL ME
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Applicant Name
Address 4il62
City /
Project Location (County, State Road, Water Body, etc.
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Type and Dimensions of Project 9, r 4 r•/ ,, V `k ;?© ,
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.
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State N;C
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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 (SCALE:
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.
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Applicant's signature
CAMA Official's signature'
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

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Rogger Schmidt
4169 Jai Rd.
�- Arapahoe, NC 28510-9519
rAPR 2 6 2001
COASTAL MANAGEMENT
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North Carolina
Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor
William G. Ross Jr., Secretary
Donna D. Moffitt, Director
May 3, 2001
Roger Schmidt
4169 Janerio Rd.
Arapahoe, N.C. 28510-9519
Dear Roger :
NCDENR
Attached is a Certificate of Exemption From Requiring a CAMA Permit to install a 4' X 20' pier with a
10' X 10' platform at Lot #1 on Hardison Lee Farm Road, in Indian Estates, Arapahoe.
In order to validate this permit, please sign all three (3) copies as indicated. Retain the yellow copy and
the attached regulation (7K .0203) for your files and return the blue and green signed copies to us in the
enclosed, self-addressed envelope.
Your early attention to this matter would be appreciated.
Sincerely,
M. Ted Tyndall, District Manager
Enclosures
MTT/rcb
Morehead City District \ 151-B Hwy. 24, Hestron Plaza II
Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: http://dcm2.ear.state.nc.us

ADJACENT REPARUN PROPERTY OWNTER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATZIFT/BOATHOUSE)
I hereby certify that I own property adjacent to Ito c- SJ1 M '4is
Marne of Property Owner)
property located at odte(" Eg 44s- G 0 / 6-p
(Lot, Block, Road, etc.)
on / `t�-Lk-Sc�. Rivea- , in � a1'a;co , N.C.
(Waterbodr) (Tow and/or County)
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION A-ND/OR DRA«'PtiG OF PROPOSED DEVELOPNfENT:
(To be filled in by individual proposing dei-elopnkF _
P/6 r7`"/V i- ;�Cep c-, Z .
Print or Type Name
R0--;2, -g2l3
Telephone Number
Date: y Q

. ADJACENT RIPARIAN PROPERTY OWNTER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFI'/BOATHOUSE)
I hereby certify that I own property adjacent to O r- C'- CG " n 's
'ame of Proper-ty' Owner)
property located at 1!'t gOcu�, �S r7 zc� lgc"4,vol- Lee Faric,
(Lot, Block, Road,
+etc.)
on use Ve , in i7ra ct �o raw ,`cv �'o, , N.C.
(Waterbod}) Tow,n an r County)
He has described to me, as shown below, the development he is proposing at that
Iocation, and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathoL,se must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
1� I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
- - --------------------------------------------------------------------------
DESCRIPTION ANIXOR DRANN'r G OF PROPOSED DEVELOPNfENT:
(To be filled in hY indii•idual proposing development)
I
NPR 2 6 200,
Signature
Print or Type Name
619 � 9--7//- K 0(-
Telephone Number
Date: O V -/ 9 -o/