General Permits (2317)

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, I L E
Department of Environment, Health, and Natural Resources and the Coastal Resources Commissio
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K A2087 , o Z68
Applicant Name rgr .,�cs E•' /-� �,'yie. r<r,'c� Phone Number 9/9- 2-V7. y/i33
Address
City State _ NC zip _ 2YS`�o
Project Locati (County, State Road, Wat r Body, etc./) �rS •„
Type and Dimensions of Pr ZI
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 (SCALE: o )
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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 gignature
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Issuing date
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Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
l hereby certify that I own property adjacent to
Charles and Catherine Emrick's property located at
Lot 15, Hardesty Farms, Sprt 1 144 Shell Bank Road,
on the Newport River, in Carteret County, North Carolina.
They have described to me as shown below, the development they are
proposing at that location, and, I have no objections to their proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
We would like to place our well between 40 and 75 feet from the high water mark
in order to have it as far away from our septic system as possible. Although 50
feet from the septic system is all that is required, The Environmental Health Dept.
has suggested that it be farther away. It would be landward of the existing river
bank, and be the required 10-foot setback from the side lot line. We would also
build a small box to protect the pump from the elements.
i
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Signature
Gerald R. or Glenda Crosby
S Yo - - 5/yi v
Telephone number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Charles and Catherine Emrick's property located at
Lot 15, Hardesty Farms, Sect. 1, 144 Shell Bank Road,
on the Newport River, in Carteret County, North Carolina.
They have described to me as shown below, the development they are
proposing at that location, and, I have no objections to their proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
We would like to place our well between 40 and 75 feet from the high water mark
in order to have it as far away from our septic system as possible. Although 50
feet from the septic system is ail that is required, The Environmental Health Dept.
has suggested that it be farther away. It would be landward of the existing river
bank, and be the required 10-foot setback from the side lot line. We would also
build a small box to protect the pump from the elements.
Signature
Norris W. or Rejeanne T. Ridgeway
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Telephone number

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