General Permits (4842)

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• CERTIFICATION OF EXEMPTI N
COI
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 io%d i / �Il'M /lee Dti lam-? */V hone Number
Address
City St to zip r
Project Location (County, State Road, Water Body, etc.)
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 tororjtinue this certification.
your obtaining any other State, Federal, or Local authorization. u ,
i
sent of a CAMA official under the mistaken assumption that the Applicant's signature
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development. CAMA Off i ial')signature
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.
Issuing
Ex
Attachment: 15 North Carolina Administrative Code 7K .0203

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
1cr hl t- i S tT Is property located at
(Name of Property Owner)
J
(Lot, Block, Road, etc.)
on �c� L C= C(c L �' , in f,'A - �, ,T- 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
Print or Type Name
124-
Telephone Number

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ADJACENT RIPARIAN PROPERTY OWNER STATEKENTT
I hereby certify that I own property adjacent to
6J/L L) is M property located at
(Name of Property Owner)
(Lot, Block, Road,' etc.)
on O� P 1 C L- CO2�G /C in /-)-I LF'ti j (C 5? t=�� f_r 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Signature
! � 4D<f
Print or Type Name
o ),LZ17-�yf-7
Telephone Number

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4
State of North Carolina
Department of Environment, Health, and Natural Resources
Division of Coastal Management
3411 Arendell Street • Morehead City, North Carolina 28557
James G. Martin, Governor Roger N. Schecter
William W. Cobey, Jr., Secretary July 11, 1991 Director
Mr. William Harrison Watson
Route 3, Box 85
Grifton, NC 28530
Dear Mr. Watson:
Attached is a Certificate of Exemption From Requiring a CAMA
Permit to construct a boat lift, 2 piers with 2 mooring pilings
at 134 Hoop Pole Creek Drive, Atlantic Beach, in Carteret County.
In order to validate this permit, please sign all three (3)
copies as indicated. Retain the yellow copy and the attached
regulation (7K .0203) for your files and return the blue and
green signed copies to us in the enclosed, self-addressed
envelope.
Your early attention to this matter would be appreciated.
WDN/dh
Enclosures
Sincerely,
� e-
W. David Noble
Field Representative
P.O. Box 769, Morehead City, North Carolina 28557 Telephone [phone]
An Equal Opportunity Affirmative Action Employer