General Permits (5000)

CERTIFICATION OF EXEMPTION
�- FROM REQUIRING A CAMA PERMIT
�d
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
I� 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.
SKETCH (SCALE: )
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n...... ,.d,.... .,­4� —ifV, � A.uninnmcnt without tha Mn-
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.
I
Applicant's signature
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

16
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SOUND VIEW PARK OWNER'S ASSOCIATION, INC.
P. O. BOX 1441
MOREHEAD CITY NC 28557
May 6, 1997
Alan Jelley
3421 Horseshoe Bend
Raleigh NC 27613
Dear Mr. Jelley,
The Board of Directors of Sound View Park Owners' Association, Inc. met on April 28, 1997. It
was their decision at that time to allow construction of a boat lift at lot B23, with the following
terms to be adhered to.
1. The boat lift be constructed according to the plans submitted to the board.
2. Approval be obtained from both neighboring property owners.
3. All permits be obtained from the proper authorities before construction begins.
We welcome you to our neighborhood and look forward to meeting you personally.
Board of Directors
Don Nickol, President
Angie Day, Vice President
Jesse Davis
Daphne Faircloth
Bill Weinhold

Dr. John S Chamblee
509E church Street
Nashville, NC 27850
Boat Lift - 1003 Linda Court
"Sound View"
Newport
I, Dr. John S Chamblee, have no objection to Alan and Anita Jelley installing a 13'3" x 13'3" boat
lift as per attached drawing. Lift to be installed adjacent to the bulkhead as shown.
Signed.... .. ..............�..... ... ....... /
Dr. John S. Chamblee
Print Name ..... 509 E Church St.
Nashville, NC 27856
Date .......... C�. ✓ .C1 ............. ...................................
..........

James W Jeffries
RT 3 Box 194
Burlington, NC 27215
Boat Lift - 1003 Linda Court
"Sound View"
Newport
I, Mr. James W Jeffries, have no objection to Alan and Anita Jelley installing a 13'3" x 13'3"
boat lift as per attached drawing. Lift to be installed adjacent to the bulkhead as shown.
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Signed ....ys�1.?...)// ..................
Print Name .... J ,lkll.� .5
Date!1...... 1 - .l .7............................................

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to 14,E#A) 's
(Name of Property Owner)
property located at PT a 2, 3 S- ..Spa,rJI
36214 'i /3,4 S IAJ (Lot, Block, Road, etc.)
on D%/— /�D(�-cc2 �0��� , in ��i�%.z i��� , 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 DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
ter_
( )6 $
y► a-45.�, .JG' 1� � �-,
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S' ature
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Print or Type Name
Telephone Number
Date: _ Co — �O -- 2 7