General Permits (6076)

F !
1�r
-Y
CERTIFICATION OF EXEMPTION l/�V/V��
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, `6
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.
'i- 1 - 7 3 /
Applicant Name � _n -'J., -- _0 � )Q • � Phone Number, �,
Address ! l Ste. L. r) > >
City "'- State Zip
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project 6
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 to continue this certification.
your obtaining any other State, Federal, or Local authorization.
SKETCH (SCALE: )
10 7-
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
ration date
Attachment: 15 North Carolina Administrative Code 7K .0203

UNITED STATES POSTAL SERVICE
First -Class Mail
111111 Postage & Fees Paid
USPS
Permit No. G-10
• Print your name, address, and ZIP Code in this box •

d
0
w
U)
m
m
d
.L.
c
0
v
a
>_
0
4)
to
U)
W
cc
0
G
a
z
M
P
W
fY
0
n,
SENDER:
■ Complete items 1 and/or 2 for additional services.
■Complete items 3, 4a, and 4b.
■ Print your name and address on the reverse of this form so that we can return this
card to you.
■Attach this form to the front of the mailpiece, or on the back if space
permit.
■ Write'Return Receipt Requested' on the mailpiece below the article
■The Return Receipt will show to whom the article was delivered wild
delivered.
3. Article Addressed to:
S ma`s 4- L
By: (Print
6. Sionature:
X
PS Form 3811,
?CO
I also wish to receive the
following services (for an
extra feey
does not 1. ❑ Addressee's Address
number. 2. ❑ Restricted Delivery rn
the date a
Consult postmaster for fee.
rticle Number
rD5-6 -? 71 S',L 7cc
4b. Service Type d
❑ Registered H�-Certified
❑ Express Mail ❑ Insured c
w
❑ Retum Receipt for Merchandise ❑ COD
7. Date of Delivery_
- � 71
8. Addressee's Address (Only if requested r
and fee is paid) r
rn

p 2"-IfErU.15:36 FAX 404 $79 .7273 FWS R4 REALTY 2002 i
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPER'CY OWNER NOTIFICATION/WAIVER FORIM
Name of Individual applying for Permit:. KENNETA WAYNE pANTET.8 TR779T
Kenneth Wayne Daniels, Trustee
$31911 750 Lola Road
Address of Property:
Cedar Island, N.C. 28520
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adj Scent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached d;a.wing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
V I have no objections to :his proposal.
If you have objections to what is bEing proposed, please write the Division of Coastal
Management, Hestron Plaza II, 15I-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808-
2808 within TO days of receipt of this not,'ee. No response is considered the same as no objection
if you have been notified by Certified Mail.
W.4.I1VER SECTION
....-----5ero�cx a mjntrrium Distance"of i`�' rrom my area of riparian access°unless wor ea oy mcm1r must
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 1 setback requirement.
I do not wish to waive the 15' setback requirement.
�f/i/
4Siggnature
f Tate
Print Name
Telephone umber With Area Code

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: K E N N E T H W A Y N E DANIELS TRUST
Kenneth Wayne Daniels, Trustee
Address of Property: 725 Lola Road
P Y�
Cedar Island, N.C. 28520
(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 II, 151-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notified 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.)
v I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
�e
le ✓ d , a ask, l �
Print Name
1 �/ 3
Telephone Number With Area Code

LLOYD GOODWIN HEIRS \S
NO REFERENCE FOUND \ 0
I, \ LINE FROM FXISTNG TACK TOi APPROXIMATE CENTERLINE 26T ` \
-ERSE'TION OF NC HIGHWAY I 8 NCSR 1388,
AAEA
BY pMD
�.y \ 415,3I -AC SF ,.`.-D.��11'
- St AVF 9.54 i-AG
08 759 PG 972
ECM
EIP KEELIE D. & J. CLAY GASKILL
\ Y 721 LOLA ROAD 0
�ExIs�I \ CEDAR ISLAND 'NC 28520,.�
j
90
i I k l a
• 'x S 1 4 2o 3'4 0"E
�I
. 1
}�
LV 179.60'
tw
O
` I TRACT 2
1
w .
C33 60L.98' �3 AREA �
—a PI
� r, n� i. p,�r�� 8Y DMG l
1 6' E 6 7.05' '� `� •.Q /, �o rI. . I. ro R, \
I h' 86 45'30"
415,363+i- SF
< \
< Z C. I ENNETH W. 8 SHIRLEY E. DANIELS, SR. D
4 a
a
iv
a
c 725 LOLA ROAD
O m CEDAR ISLAND NC 2852C V"
2 O .. r ''`• NC APPROVAL RE CU:REO 9Y THE CARTERET
O;
r- 9 0 R T
V EPG hEN I O O 00,
b Q CCUN� PLANN'NG D T
{'s COUNTY PLANNING DIRECTOR
N F I NORTH CAROLINA, CARTERET COUNT
IN ^BEM .' 1 1 t tt %Z I.22' U.S. FISH AND WILDLIFE 5ERL7CE THE FOREGOING CERTIFICATE(S) OF 75C___:r______
T I �t3� A1j D8 712 PG 273
85o26'36%�' IS (ARE) CER?IF IEO TO BE CORRECT. THIS INST-
•Tp�'RnAdmA(�� ',98' (TOTAL
• I ! PRESENTED FOR REGISTRATION AND RECORIAD IN
i "r!p�
-CM i OFFICE IN BOOR ------- PAGE .......
THIS _____ DAY OF ______: 19___ A.

N/F
LLOYD GOODWIN HEIRS
NO REFERENCE FOUND
Ay1
2�
• s.
• , IRS
I °
-IE LINE FROM EXISTING TACK TC APPROXIMATE '.ENTERLINE Qc� hDt
NTERSE _TION OF NC HIGHWAY 12 8 "ICSR :388.
�0T143 ACT 1 �•.. :, ,� '-�
AREA C s
`v EY V'MD
tiF 415,364+i- SF U ! N�• c�6', ,/�
�?90 NiF 9.54 /-AC=
GOODWIN
3B 759 FG 972
S(9
A
,\
' KEELIE G. & J. CLAY GASKILL
k
�\ \E P 721 LOLA ROAD � O�`. \\
CEDAR ISLAND NC 28520
,� �i , I _ � �O p . Ica. � �•
1 x
N �� • 179.60'
p N M
1• 1
TRACT 2 _ a
606.98' _a �, 3 AREA
7' 6Y DMD �C
1--'��I� r` r'
6 415,363+1- SF R-
�,� 86 45'30 E 637.05 '�'��-� � . /, alo ��.L , _ � ��•� _
a \
IRCP P.T(k- ,IlIJ�•C 9.54+z-AC X
0 Z O l�0Z P oa\
< i .. C' (ENNETH W. 8 SHIRLEY E. DANIELS, SR.
j iv c 725 LOLA ROAD
j p p rT). CEDAR ISLAND NC 28520
r O NO APPROVAL RcOUIRED BY THE CAR7ERE-
o
22. COUNTY PLANN .'JG DEPARTMENT
7 II I ,1 COUNTY °LANNING DIRECTOR
O �I 2
6' N F NORTH CARCLwA, CARTERET �C!
IAI
• IN EM ' �� 721.22' U.S. FISH AND WILDLIFE SERVICE THE FOREGOING CER' I F i CATE(S) OF ------- -
D8 712 PG 273 IS ( ARE ) CERTIFIED TO BE CORRECT. TH'`
,
N
, , : 85°26'36 W 75C.9 T.
�- � �; 8' (TO.,.u) PRESENTED FOR REGISTRATION AND RECOn;.E_
I / EIP ErM
1 / OFFICE IN BOOK PAGE -------
i f THIS ___-- DAY OF ------- 19--- AT ----