General Permits (6460)

CERTIFICATION OF EXEMPTION cnr
FROM REQUIRING A CAMA PERMIT 8_00
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 C.. -e I I rj,
Address
City r
Project Location (County, State Road, Water Body, etc.)
State
Phone Number Z k a ac
Zip / t
Type and Dimensions of Project 1? ' 'k ( �
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. T� y 1 j %
your obtaining any other State, Federal, or Local authorization.
SKETCH _ 2 n ' (SCALE: )
i
l � !
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.
ar
r
Applicant's signature
CAMA Official's signature
2—
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE) ''J �'-1 x'�p �
I hereby certify that I own property adjacent to l?l 's
(Name o Prope Owner)
property located at
(Lot, Block, Road, etc.)
1
on , in �' , N.C.
(Waterbody) (T wn and/or County)
c has described to me, as shown below, the development °Ne�is proposing at that
location, and, I have no objections to his proposal. I understan' d that a pier/mooring
J P Po P g
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
14 At 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)
�exist;'ng CeXiSJ-i'Y1 h'o
pilih5V p�in�� _ ix;silinC
`Pr posed Ian �r
�zi boa��sl�p,
I(�Oai �-1-0
se � ex+en Si oh +Owarj
ewSt1 h3 r 10 Alh9
r2Xi 5'�i,n� �in9er do�1�)
Sig�4ehe'�
nature
Print or Type Name
12�9 -- �/8199
Telephone Numbe
Date:

,?j �- , -), J, &/
Water Depths for Faye Styron's Property
ALL DEPTHS AT M LW
Shore Edge & Dock- minus 6 inches
10' - l foot
20'- 1.5 feet at offshore piling
Offshore of Piling in Middle of Channel
15'- 1 foot
X4,0 re UA to
25'- 6 inches;
3 5'- 0 inches - r'i
45'- 0 inches
55'- 0 inches
65'- minus J inches.
75'- 0 inches o O
85'-1 foot
95'- 1 foot
105'- 1.5 feet
115'- 6 feet
125'- 8 feet���5
135'- 12 feet ��

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ro1
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v
f ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent toC�l
(Nam of Prope y caner)
property located at
(Lot, Block, Road, etc.)
on , in , N.C.
aterbody) (T n and/or County)
e has described to me, as shown below, the developmeXdthat"a
proposing at that
n locate , and, I have no objections to his proposal. I unders 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 DEVELOPNIENT:
(To be filled in by individual proposing development)
exisfing 0Pyl►^g
',��iropose� plAn �r
rize� boar slip)
ext ng
pi i ng
Print or Type Name
17
Telephone Number
eyaI
pity
eX'�sio
eXf6ng 1
Date: �
pilina

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