General Permits (6223)

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 of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name
Address
City
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.
Phone Number
State Zip
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: )
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
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

A McCauley Moving & Storage
of Fayeneville, Inc.
135 South "C" Street -- P. O. Box 654
Fayetteyilic, North Carolina 2B302-0634
Tvlcphone 910/483-4195
Fax [phone]
TO: Georgia Poavall
YROm: Albert 0. McCauley
Pages: -1-
DATE: 17 Dec 1997
I prefer we leave setback. 15' as required. I feel
this is.,in the beat interest of all parties concerned.
41

4
ADJACENT RIPARIAN PROPERTY OWNER STAT=\rT
I hereby certify that I own property adjacent to
/L/ ILI 11:rx/u%�.5 _'s property located at
(Name of Property Owner)
A Z/,
(Lot, Block, -Road, etc.)
on N.C.
"./, in 0'- ; 1, 1 1) 1. -J - : r *. L.I. , "
(Waterb6dy) (Tawas 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)
i
-I.-,) C
Signature
Print Print or Type Name
Telephone Number

I hereby certify that I own property adjacent to
property located at
P P Y
( Name o Property owner)
r7,
(Lot, Block, Road, etc.)
on }�l �� L T �'�iJ C' t.' 11� in 011.w `) L3 C i, <; ��'�� N 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 filled in by individual pro ing-detelopment)
14/ 1
-
i
I
i
-SIgftature
Print or Type Name
V�
p�phone Number
Z-W
V
Op

_....._
dHjjK H s >t F i� �K• \7 �� 1 �V✓ So.�r°y('�nSl t7( Y• 1F...,1
--- _ MEAN r,pr
zrz7Tiz l },1 �� N •,ten - o�
J � jj � hJE hF Lryf l_tl,lti
(1 3
T
VIC/N1TY MAP not to stole
FX. �fBAQ o.23,
ly
fJt>-jE, <-fEPS tit l Lo
LItaE i-�T S-r�t✓F.T
:i
V�w
.l
I -A
sY--
W r'a 1_ , ST
W
r- •F� y
rr�rlef ' °
LIr1F5-_
(CooFD. M�-Mon
z• S
-f�
°�1 vr_cK I
r i L.c" Zl.lof�
CP,-
,�'
N
d
r •�
Pam,/�P} hJroz"�,3'os'E
f'<<�lF. � O • OO
NOT FOR RECORO/NG
1,PArE D. PH,CC,PS HEREBY CERrlFY S URVE'Y
THAT rNIS MAP WAS OR4I4VN UNDER MY
SuFF/7VJ5IG.: rFi.A'.. .. UAL SURVEY
e MADE UNDER Mr sUFERv1s1oA,, rNAr me I 1
T RAr/o OF P/7,ErYS/R r S.-.4ZCUCArCD BY
tArrtruOE�S •� bEvtii�d/A�,� 1s I 1 Q0 J/ `c c✓ I
r rHAr rNi ,NAP("W �tPR1,�AA�D /N
ACCORVA�' �iT1/J O�$04�� 30 A•5 AMEND- ljSA����>gof O 11�>P !7{�1510 /f LO
ED. w/rNESS Mr HAND AND 'TEAL e rN1S
_1L�oAY oF�E°�_�' _ e199� NORTH _ CAROL /NA
l.rfrfl
z J + SCALE
st'
d
Mt(ALI' r.,( s
M�vor.lnl_�
{J
ll.f�y;Yt�e.t_I'ts,
•
- 1FIG,
t�
ICa. 1lnh
1�1T ti/A-7r tilFjir
ST• ,
FOR
f,i j
P� � I-J
REF' p13, b i5 Via. I►1
✓'1JS1_o\�./ COUNTY RE6/STRY'
o • i "
'•f•'�° " PATE PH/CLIPS ANo ASSOCIATES P.A.
PO BOX 214
REc/srERED sunv£roR No. G-iJo4.6 SWANSSORO NORTH CAROL/NA
PROJECT NO. —

Location: �°� C. -E� C;-� ^n j�o Field Rep.
O Phone: Date of Report:
Description of Project: G
Date Project Reportedly Complfftte :
(1)' Do the measured dimensions of the development -iffer from those
indicated in the permit .and work -plat?, Yes / FavE all permit
conditions been satisfied? No
CON7=NT :
(2)
(3)
Ccr- i r=n tc-ic) an,d E res i Gn Cor,try I
cr ct^er'Yl�sC zeld all G1s�t'.rDEd arcs
i
cr EnforcEment action needed?
CO=NT :
crassea ,
i _
=c fttrt..Er i nvestlaaticn