General Permits (4121)

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
�o�f�environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name "Jf-) � Phone Number
City `.R,K, -\ 14, . 9 r � 1e
Proje8 cation C unty, State Road, Water Bbd , etc.)
. U Cam- cr3�
and DimeusiWe,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.
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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.
I SKETCH (SCALE: ) I
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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.
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CAMA Official's signature Q—J
�_ S�-�i
Issuing date
r� 17
Expiration date
7
Attachment: 15 North Carolina Administrative Code 7K .0203

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CERTIFIED MAIL • RETURN RECEIPT REQUESTEDx
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIRCATIONIWAPVER FORM
Name of Individual applying for Permit:
Address of ProFertS':-
249 Live Oak Rd:
Newport, N. C.
Claud L. Dunn, Jr.
Carteret County
(Lot or Street {f, 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 described 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, Hestron Plain H, 1518, Hwy. 24, Morehead City, NC, 28557 or call (919) 808-
2808 within 10 days of receipt of this notice. No response & considered the same as no objection
if you have been notifaed by Cet faed 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 15' setback requirement.
�X-- I do not wish to waive the 15' setback requirement.
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Signature Date
Lee C. Jones
Print Name
919-393-1469
Telephone Nurriber 'With Area Code
TOTAL P.02

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Proposed pier and "T" section are in excess
of 15` from the adjacent property lines
extended into the water at the points that
they intersect the shoreline.
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CERTIFIED MAIL- RETURN RECEIPT UQUESTED x
M,.,.
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: Claud L. Dunn, Jr.
249 Live Oak Rd.
Address of Property:
Newport, N. C. Carteret County
(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 described 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, Hestron Plaza 11, 151B, Hwy. 24, Morehead City, NC, 28557 or call (919) 808-
2808 within 10 days of recefpt of this notice. No response is considered the same as no objection
if you have beers notched 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 15` setback requirement.
t/ I do not wish to waive the 15' setback requirement.
AP-4 °�fz= Z/J/-g -2
Sinnature Date
Charles D. McClees
Print Name
919-393-7829
Telephone Humber With Area Code
TOTAL P.02

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Proposed pier and "T" section are in excess
of 15` from the adjacent property lines
extended into the water at the points that
they intersect the shoreline. AD