General Permits (2338)

C
A CERTIFICATION F EXEMPTION
/ � C ATi N O C O O N eon
FROM REQUIRING A CAMA PERMIT ,.
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..��—�/ = 1i'` C�'� �"" �� { Phnnp Niimhpr '� ye/ > ',! Vle
Address
City 'I n ` ' State
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project ! 4
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.
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.
j SKETCH (SCALE: ) j
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.
400
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 signatu
CAMA Official's signature
Issuing date �.
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

OUTER BANKS
` MARINE CONSTRUCTION
Post Office Box 1988, Atlantic Beach, NC 28512 DOCKS - SEAWALLS - FLOATING DOCKS
[phone] Dealer for Davit Master Boatlifts
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375 P02 DEC 08 '94 13:04
ADJACENT RIMRIAN PROPERTY OWNER STATEI1"ENT
ON —
I hereby certify that •? bun property adjacent to
TxIaAe
located at ,CPT S `9
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's properly
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(Lot, Block, Rgfmd, etc.)
e'7evo .�r e��" i n rJ N . C .
(I,later ]Body) (r county)
lie has described to ne as shown below the deve3opment he -is
proposing at that location and 3 have no objections to his
proposal. I understand that a pier must be set back a minimum
distance of fifteen feet 125') from ny area of riparjen access
unless vaived by me.
do not wish to 'Yk,•aive that setback requirement.
1 do Wish to W?'Iye that setbarl: requirement.
Description and/or exa ing of pm;>Dsed 6eve3opment: (70 BE
FI1..TI N By 7 N7D3VID'JAL V�ROPOSI N G DEti'EiIOPXI N`T)
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