General Permits (3393)

t e '4. 21
-
CERTIFICATION OF EXEMPTION
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 NamePhone Number
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
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'r'e=examination of the project and project site may be necessary
to continue this certification.
I SKETCH (SCALE: /r,•t. )
Y{ar i , Ji'`., r. -4.
IT
Ali-
10
� r
'j 1
" r of
>f
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 signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Dear Mr, L7mNi1 /5oSfee- :
This letter is to notify you as an
Mr. Mrs. of // f -rlxl A &II, 661AI
adjacent riparian landowner of
plans to construct d
WR6414J,117rCf-0 a ,5 v,- D n i P
on their property located at LOT
in i eh)-Ser.,Y , NC. The sketch on the reverse
side accurately depicts the proposed construction.
Should you have no objections to this proposal, please check the
statement below, sign and date the blanks belowthestatement,
and return this letter to: �i�5Ti9L / �%el Vz---
as soon as possible.
Should you have objections to this proposal, please send your
written comments to the NC Division of Coastal Management, P. O.
Box 769, I�orehead City, NC 28557. written comments must be
received Within ten (10) days of receipt of this notice.
Failure to respond in either method within ten (10) days will be
interpreted as no objection.
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 `q
DATE:

�Db��1e
�7� 9D/�,
�����
�3y-�o�g
�gM�
% �� ' ��D'7

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIA100RING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 9" // 4 TNA Co11 SDI! is
(Name of Property 0;-ner)
property located at ' ,� %9 %4elleA, C7- i2A,5,,elm
(Lot, Block, Road, etc.)
on D,rba� oFF 3ntes Clee4- in 1 Pc� be�� /t%L , N.C.
(Waterbody) (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. I ' understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRA«'ING OF PROPOSED DEVELOP.NTENT:
(To be filled in by individual proposing development)
See
41,
Signatur
bou 6 �>(Lm-")
Print or Type Name
919- 63G -3.7aD
Telephone Number
Date: Z " / 7.9X-

266 3
2-17-yS
fro po5e aI W P6 Kw/4 f
qNd
Doc. k Fa e $, ti a -71Nw Collls61v
tar a�9
d1 e/lLON Lour
��ro/rJ Fd,Q
�� P�o�r fY �TSE,QvicE
ke
r
f
I

-
w
22.271 sq.ft.
0.51 acres
,/
t - 50
47
Coll
CD It
C-42
32,209 sq.ft.
'►� 194 �\ `� `\ 1 \\ �{ 0.74 acres
,� p N
24,814 sq.ft.0.57 acres� \\\ 1I - --_� L%
_ .
5 68'20 E \75.74' S 4 -1
U
19 404 w
p 0 36,475 sq.ft. I
/ v' �/
0.84 acres
L
283 _
Q 3
sq.ft. 1 -_. �/ _, 70.88
'acres
ro��� 4) 98,209 sq.ft.��' ��� 2.25 acres \
/ 1 0
�Ssw
06,
1,818 sq.ft.
.42 ocres
'TLANDS
1 .o e.c� •
/ r---
0
/ ! /
/ 32,610� sq. ft
0. /
/ .75 acres �3
/ c� i
43.258 sq.ft. /------------11
0.99 acres 2*
t
n
_3 , 4 ,n
-Q.'RVE DATA
CURVE RAD 1 U5 LENG'',
C-01 450. 00' 223.
C-02. 450. 00' 214. s
C-03 450. 00' 8.
rn C-04 500.00' 92.
\23.9�5 \� W C-05 500. 00' 160.
N 77' C-06 350. 00' 221.!
\ C-07 225. 00' 450.
C-08 225. 00' 171.
C-09 225. 00' 278.
C-10 475.00' 70.
C-11 475. 00' 112.
C-12 20.00' 29.
I C-13 50.00' 67.
I C-14 50. 00, 54.
C-15 50.00, 96.:I
C-16 25.00' 2.
C-17 25. 00' 28. r
C-18 20.00' 31.
C-19 525.00' 43.
/ C-20 525.00' 52.
C-21 525.00' 166.
C-22 325.00' 194.
C-23 325. 00' 83.
C-24 20. 00' 29.
% C-25 250.00' 89.
C-26 250.00' 79.
/ C-27 250. 00' 77. !.