General Permits (6303)

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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMITS
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.
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Applicant Name , r 6: Phone Number 7�
Address
a
City -> State Zip C t U
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project f'
3
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.
development is exempted, will be in violation of the CAMA if therei�k
is a subsequent determination that a permit was required for the
development. CAMA Official's signature L
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 date
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Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

ADJACENT REPARL.AN PROPkXJL* y U WiNtA ,1 L s =vir i'N i
I hereby certify that I own property adjacent to 1 n H 4s pi Y P. .111 n Y i A T H A M __9 S
(Name of Property Owner)
on QQRF SOUND s M CART R TT MINTY . N.C.
(Waterbody) (Town and/or County)
He has de=bed 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 DEVELOP.MEN'T
(To be ,jilted in by tndtvUual proposing development)
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L'opi
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Pr-mt or Type Name
JAN 2 1 1998 /q - 7�
Telephone Number
Date: // /Ig-

BERNICE OIXON
j MES RITCHEY
538,i390
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487/308
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ADJACENT RgPARIAAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to j O H Pi PJ Y& j i i n Y I A T H A M I
(tame of Property Owner)
property located at nAyT,, �oiirjn ! AuF nFF r(1mmmiTTY Rn nay T, PJC
(Lot, Block, Road, etc.)
on CORE SOUPJD in CARTFRFTT COUNTY � N.C.
(Waterbody) (Town andlor County)
He has described to me as shown below, the development he is proposing at that location,
and, I have to objections to his proposal.
DESCRI=ON ACID/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
$ign
J A N 2 1 1998 Pri.*zt or ype N
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Li-L-
Telephone Nam er
Date: L

BERNICE DIXON
S Se•<c;o=
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jAME5 RITCHEY
538i390
,AMES RITCHEY
4871308
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