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CERTIFICATION OF EXEMPTIO O\
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FROM REQUIRING A CAMA PERMIT''
as authorized by the State of North Carolina, n`/ II
Department of Environment, Health, and Natural Resources and the Coastal Resours ��1r1�is�io� 1994 li�'!' '
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203. u
Applicant Name Phone Nur OF------asse,..........M,
Address
City :' i State "p, . Zip
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.
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 �'' i 1 i �' (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.
CAMA
Issuing
J ,
s signatur
ficial's signature
ate
I.
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203
DI`'iSI_ON OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONLWAIVER FORM
Name Of Individual Applying For Permit: 01? A) N
Address Of Property: �CpSr�'1fmL' v�,} �`�'�- 66y$-S �f/V'o
AIL
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above -
referenced property. The individual applying for this permit has
des clibed to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions,
should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the
Division of Coastal Management, 127 Cardinal Drive Extension,
Wilmington, North Carolina, 28405 or call 910 395-3900 within 10
days of receipt of this notice. No response is considered the same
as no objection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
house, lift or sandbags 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 151setback requirement.
/ I do not wish to waive the 151setback requirement.
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Print Name
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Telep-hone NumberWith Area Code
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f & S Marine Contractors, Inc.
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Ughtsville Beach, NC 28480
(910) 256-3062
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P Box 868
Wrightsville Beach, NC 28480
(910) 266-3062
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THE FIGURE EIGHT ISLAND COMPANY, INC.. .
ROUTE B. BOX 169, RALEIGH, NORTH CAROLINA 27607
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SECTION 9 BLOCK n LOTlilt
FIGURE EIGHT ISLAND
NEW HANOVER COUNTY, HARNETT TOWNSHIP, NORTH CAAOLINA
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