General Permits (2388)

CERTIFICATION OF EXEM:PTI
FROM REQUIRING A CAMA PERMIT �' `{' MAY 0 5 1995
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Re
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203?� ---^---------+•aa.�,w�.
Applicant Name Phone Number r
Address
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project
The proposed project to be located and constructed as described
This certification of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit re-
valid for 90 days from the date of issuance. Following expiration,
quirement pursuant to 15 NCAC 7K .0203. This exemption to
a re-examination of the project and project site may be necessary
CAMA permit requirements does not alleviate the necessity of
to continue this certification.
your obtaining any other State, Federal, or Local authorization.
SKETCH (SCALE: )
i
C*
4 , �__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.
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 Official's signature /
t/ orc 5
Issuing date
f% I/ / �'
Attachment: 15 North Carolina Administrative Code 7K .0203

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER,)
I hereby certify that I own property adjacent to
1 ,
T� £ �rn� t1Qv _ � S
(Name of Property Owner) Property located at
(Lot,
ock, Road,-- etc,)
on e "
(Waterbody) in L �& N.C.
(Town and/or County)
He has described to me, -as shown below, the development he
that location, and, I have no objections to hisis prOP°sing at
that a pier must be set back a minimum distance of proposal.fifteen feet understand
MY area of riparian access unless waived by me. ) from
I do not wish to waive that setback requirement.
,7-' -
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development}
a
SSG T�RO-uJz�kJC,
Signature
Print or T 1d
YPe Name
Telephone Number

M
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Dear
DATE _67,- 5_5_&/ �_
This letter is to notify you as an adjacent riparian landowner of Mr/Mrs.
G �PL
r
E L�/"�tll}'J Axes
plan to construct _ i�}
� r,� �I'Qf}TZ
on their
property, .30la I�%�'�je
in
The sketch on the reverse side accurately depicts the proposed construction.
Should you have no objections to this proposal, please check the statement be-
low,
sign and date
the blanks
below the statement and
return this
letter
to:
as soon as possible.
Should you have objections to this proposal, please send you written comments
to NC Division of Coastal Management, 127 Cardinal Dr. Extension, Wilmington, NC
28405. Written comments must be received within 10 days of receipt of this notice.
Failure to respond to either method within 10 days will be interpreted as no ob-
jection.
Sincerely,
I have no objection to the project as presently proposed and
hereby waive that right of objection as provided in General Statute 113-229.
I have objections to the project as presently proposed and
have enclosed comments.
Signature
Date

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