General Permits (1705)

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT ap
as authorized by the State of North Carolina,
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
Address
Citv
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project
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.
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.
Phone Number
State
Zip
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.
Applicant's signature
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
'0 property located at
(Namfe of Property Owner
ee Skvrel/we ;p/1. i,4(lT'7) AT4*,yTP,,8&AC
(Lot, Block, Road, etc.)
on 'BdGue- SoyAld in ATZAWTie, —Sch04 N.C.
(Wa erbody) (Town 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Print or Type Name
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Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEKENT
I hereby certify that I own property adjacent to
Z4,0iLl 's property located at
(Name 6f Property Owner)
-P�, C�arZ > k4yrlc,
(Lot, Block; Road, etc.)
on 96 j Ue. SU Li in Ar, 4,vrlc. DwA , , N. C.
(W terbody) (Town 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Signature
PA Al FlIA
Print or Tylpe Name
Telephone Number

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U.S. ARMY CORPS OF ENGINEERS
Wilmington District Cd
AUG 0 5 1998
Action ID: _lq q $O 19 30 County: Car %cue �
/11-�
Notification of Jurisdictional Determination
Property owner/Authorized Agent far_ r: R e,
Address '� s 1 (� �►� S� /t'i;) d
C
Telephone Number °f J 9 247 1 E J 3( �") o f 1 956 6 rr j "5 j w�
Size and Location of Property(waterbody, Highway name/number, town, etc.)`
Araner �r is l oc.,g4e oN +{,e SounLzde' CV- Hwy 59 at `BOO S]�ce�;tie
n}
Indicate Which of the following apply:
C
• There a wetla on the ove describeproperty whi a strongl gest sho a delineat nd
sury ed. surve wetland lin must be ver' by ours before th rps will e a final
is� al deter oration on rproperty.
J Y
• Because of the e of your proZin
sent workload r identificatio and delineation our
wetlands ca of be acco fishmanner. Yo ay wish toe y a consultant btain a
more ti y delineati of the your co tant has fla a wetland line o e property,
Cortaff will re ' w it, and, ie st gly recomme that you have t me surveyed f
fi approval the Corps. Tht e a final juris ctional determin ion on your pr rty
without an approved survey.
�� The wetlands on your lot have been delineated, and the limits of Corps jurisdiction have been explained
to you. Unless there is a change in the law or our published regulations, this determination may be relied
upon for a pe iod not to exceed-kree years from the date of this notification
vt
• There ar no wetla s present on a above descri property w are subXange
he permit
requir ents of S tion 404 of th lean Water Ac USC 1344). nless there is in the 1
or r publish regulations, t determinatio ay be relied upo or a period not three ars
f m the dat of this notific ion.
% The project is located in one of the 20 Coastal Counties. You should contact the nearest State Office of
Coastal Management to determine their requirements.
Placement of dredged or fill material in wetlands on this property without a Department of the Army
permit is in most cases a violation of Section 301 of the Clean Water Act (33 USC 1311). A permit is
not required for work on the property restricted entirely to existing high ground. If you have any
questions regarding the Corps of Engineers regulatory program, please contact
K: M WQI �t J Day; d IZA00 atT) 25 I - Li 6 ! 1
Property owner/Authorized Agent Signature
Project Manager Signature C
Date —7 /so/aj,
Expiration Date -713 O / 03
SURVEY PLAT OR FIELD SKETCH OF DESCRIBED PROPERTY AND THE WETLAND
DELINEATION FORM MUST BE ATTACHED TO THE YELLOW (FILE) COPY OF THIS FORM.
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