General Permits (4571)

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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 Commissi
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name Phone 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 re-examination of the project and project site may be necessary
to continue this certification.
I SKETCH (SCALE: 51%l '77- ' )
.. J -•�W�-•ems..' � ..
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
ssuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

IPS Form 3800. April 1995
r P.O. Box 1647
Morehead City, N.C. 28557
Lddie [phone] l
Cameron
ONSTRUCTIOKy mc.
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Mr. & Ms. Robert S. Nichols Sr
PO Box 126E
Swansboro, NC 28584
Dear Mr. & Ms. Nichols,
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This letter is to notify you, as an adjacent landowner of Charles and Mary Ingram, that he plans to
begin constriction of a new dock and seawall.
Should you have no objections to this proposal, please check the statement below, sign and date the
blanks below the statement, and return this letter to Eddie Cameron Construction, Inc., PO Box 1647,
Morehead City, NC 28557, as soon as possible.
Should you have objections to this proposal, please send you written comments to the NC Division of
Coastal Management, Inc., PO Box 769, Morehead 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,
10
Eddie Cameron III
..ddie Cameron Const., Inc.
I have no objection to the project as presently proposed and hereby
that right of objection as provided in General Statue 1 13-229
I have objections to the project as presently proposed and have enclosed 1 1999
comments. - '
Signature and Date
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P.O. Box 1647
Morehead City, N.C. 28557
Gddie [phone]
Cameron
ONSTRUCTiON, mc.
Mr. Don Mills
827 Gurnbranch Road
Jacksonville, NC 28540
Dear Mr. & Ms. Mills,
PS Form 3800, April 1995
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This letter is to notify you, as an adjacent landowner of Charles and Mary Ingram, that he plans to
begin construction of a new dock and seawall.
Should you have no objections to this proposal, please check the statement below, sign and date the
blanks below the statement, and return this letter to Eddie Cameron Construction, Inc., PO Box 1647,
Morehead City, NC 28557, as soon as possible.
Should you have objections to this proposal, please send you written comments to the NC Division of
Coastal Mana-ement, Inc., PO Box 769, Morehead 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 (1.0) days will be interpreted as no objection.
Sincerely,
Gddie Cameron I[[
Eddie Cameron Const., Inc.
I have no objection to the project as presently proposed and hereby
that right of objection as provided in General Statue 1 13-229
I have objections to the project as presently proposed and have enclosed
comments.
JU.! c 1 1999
Signature and Date

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FOR IeA::e --Ic-,%
DATE TIME��� P.M.
M j P (Y�(ln �Zt�lTJ
PHONE 9 G(� Q KJ- Wa--1
EA CODE NUMBER .EXTENSION
❑ FAX
p MOBILE
AREA CODE NUMBER TIME TO CALL
TELEPHONED
PLEASE CALL
CAME TO SEE YOU �
Wiiwk GALL'AGAIN
WANTS TO SEE YOU ' '
RUSH
RETURNED YOUR CALL
SPECIAL ATTENTION
MESSAG
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SIGNED
FORM 3002P
LITHO IN 11.5 n.

,',Locality Permit Number
`;;GENERAL INFORMATION
V,,LAND OWNER
Name �'harle v Ingram 5 Mary 1 Inaram
jV L... _
:'Address 1519 Stoneridge Dr
t City. S a n f n rd State NC Zip 27330 Phone
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g'AUTHORIZED AGENT
Name Lddie—t'amernn Cnnst Inc: _
�,+sAddress PO Box 1647
;.City Morehead city State NC Zip 28557 Phone[phone]
LOCATION OF PROJECT 121 Harold Avenue, Lot 311, Hurst Harbor North _
Swansboro, NC
(If not oceanfront, is waterbody natural or manmade?) Natural
DESCRIPTION OF PROJECT __ Seawall
n AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
'(To be filled in by the Local Permit Officer prior to completing application.)
Qcean Hazard Estuarine Shoreline ORW Shorelin Other
PROPOSED USE
tf Residential Commercial/Industrial Other
`RSQUARE FOOTAGE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR
-,BUILT-UPON SURFACES (such as driveways, etc.) within 75 feet of the shoreline (575 feet
';of an ORW shoreline)
QUARE FOOTAGE OF TOTAL FLOOR AREA OF BUILDING
SQUARE FOOTAGE OF SITE 21,403 s q f t
-The activity you are planning may require
''permits other than the CAMA minor
development permit. As a service we have
compiled a listing of the kinds of permits that
might be required. We suggest you check
over the list with your LPO to determine if
any of these apply to your project.
Zoning, Drinking Water Well, Septic Tank
(or other sanitary waste treatment system),
Burning, Electrical, Plumbing, Heating and
Air Conditioning, Insulation and Energy
Conservation, FIA Certification, Sand Dune,
Sediment Control, Subdivision Approval,
Mobile Home Park Approval, Highway
Connection, and others.

STATEMENT OF OWNERSHIP _
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in
an AEC or a person authorized to act as an agent for purposes of applying for a CAMA minor development
permit, certify that the person listed as landowner on this application has a significant interest in the real
property described therein. This interest can be described as: (check one)
an owner or record title, Title is vested in dn , see Deed Book 3 2 ,
page 42 in the onslow County Registry o Dee s. slide # I-30
an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County.
if other interest, such as written contact or lease, explain below or use a separate sheet and attach to this
application.
NOTIFICATION OF ADJACENT PROPERTY OWNERS
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I
have given ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for
a CAMA permit.
(Name) (Address)
(1) Don Mills 827 Gumbranch Road, Jar-kGpnxri 1 1,- Nr 2A940
(2) Robert S _ Nichols Sr 20 Box 1262, Swansbnro Nr 28584
(3)
(4)
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
I acknowledge that the land owner is aware that the proposed development is planned for an area which may
be susceptible to erosion and/or flooding. I acknowledge that the local permit officer has explained to me the,
particular hazard problems associated with this lot. This explanation was accompanied by recommendations
concerning stabilization and floodproofing techniques.
PERMISSION TO ENTER ON LAND
iO
I furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer ; r=
and his agents to enter on the aforementioned lands in connection with evaluating information related to this
permit application.'
This application includes: general information (this form), a site drawing as described on the back of this ap-
plication, the ownership statement, the AEC hazard notice where necessary, a check for $50.00 made payable
the locality, and any information as may be provided orally by the applicant. The details of the application as
described by these sources are incorporated without reference in any permit which may be issued. Deviation+X
from these details will constitute a violation of any permit. Any person developing in an AEC without a per-
mit is subject to civil, criminal and administrative action.
This the day of ,19
4 vF
Land owner or"person authorized to act as his agent'
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for purposes of filing a CAMA permit application.

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SENDER:
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Fi,ng services (for an extra fee):
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❑ Complete items 1 and/or 2 for additional services.Complete
t items 3, 4a, and 4b.
Print your name and addr=-ss on the reverse of this fo m so that we can rehim this1 ❑ Addressee's Address
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card to you.
❑ Attach this form to the front of the mailpiece, or on the back if space does not
2. ❑ Restricted Delivery
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permit.
❑ Write 'Retum Receipt Requested' on the mailpiece below the article number.
to whom the article was delivered and the date
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PS Form 3811, ece er 1994
102595-99-B-0223 Domestiq. Return Receipt
d St�1DER: i also wish to receive the follow
o ing services (for an extra fee):
y ❑ complete items 1 and/or 2 for additional services.
m Complete items 3, 4a, and 4b.
i p Print your name and address on the reverse of this form so that we can return this 1 ❑ Addressee's Address
m card to you.
d ❑ Attach this forth to the front of the mailpiece, or on the back if space does not 2. El Restricted Delivery
permit.
CD❑ Write 'Return Receipt Requested' on the mailpiece below the article number.
❑ The Return Receipt will show to whom the article was delivered and the date
p delivered.
m 3. Article Addressee) to: 4a. Article Number
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if requested and
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