General Permits (6552)

CERTIFICATION OF EXEMPTION a�
� c
FROM REQUIRING A CAMA PERMIT J� _e,—f %
as authorized by the State of North Carolina, MAY � 199$
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..17
Applicant Name i' �' 1 .. r' C Ii r` 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: )
LA'-
I
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 si n7atwod
CAMA Official's signature
Issuing date
Expiration date
L4' 4 2
i
Attachment: 15 North Carolina Administrative Code 7K .0203

C
AATACFNT RIPARIAN PROPERLY OWNER STA71F2 fEN'r
(FOR A PIB)t/AfOORING PII RUGS/BOATU'FTBOATIIOUSEa
I hereby Certify that I own Propezty adjaoemt to VA t-L E C I LLo
(N>�e of Property Owner) s
ProP�y IocaLed at �` �. I� qVt s 3
1 1 a-0, Block, Roa etc.) '
on t2RTF rZ- in EAUFeRY— C-&nTFgPr Co. N.C_
(Waterbody) (Town and/ar Conaty)
lie ha3 described to me, as shown below, the
location, �t be is proposing at
that
and, I have no objections to his propel. I understand that a vier/mom,
Y�PS�� tlift/t�g� mnw b" to 5e i �+:j rllm (1st8IiCL Of ft f d M my area of ri arian access unless waived by nle.
49-99 wish to waive the whack requizs .
I —oo wish to waive that setback requkemML
DFSCRIP'MN AND/OR DRAWING OF PROPOSED DEVEWMaNT:
(To be filled in by iwdzvidudpmposGsd devedttrtt)
A
•
nary L,tiF �y
'2zo
33 �
lf� y
Print or Type Nam
_ -48- K-1- 733/
Tekowe Number
Date: 2- 3 CIB

� S
'ADJACENT PfpARIAN PRUYERTY OWNER STATEMENT
(! ()R A PIERlMOO�NG PIIJNGSIBOA7LIF1%ROATNOUSE) ;
t
I hereby certify that I own property adjacent to A IA E e- t LL oS.
r
_22 (Name or Property Owner.)
property located at
V (1 ot, Bieck Road
on _ ORTt��wt R^
!Water --' m - AU F0 (t t--- e Aft. �' c
body)
(Town and/or County) f
He has described to rile
as shown below, the development he is proposing at that
location, and, I have no objections to
�,itin • n.� , �,. his propn r31. ? �; der;;anu It
a pie;/mooring t
r t;s-, . aw� uvatirouse must be set back a minimum distance of flfteen feet (15') from my area
of riparian access unless waived by me.
i r
of wish to waive the setback requirement.
[ #1Q wish to waive that setback requirement. t
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CFOI)ESCRT-nON A.NU/OR DRA RING OF PROPOSED 1JEV f
Ei oYMENT: I be filled In by individual proposing development) k
i
ARra ;
33
- -- - _
I , e �_---
_0ON SI"K:t-
Print_ or Type Name
,3t0 g /�,
'Telephone Number J `�— "—
Date:

JAMES B. HUNT JR.i"4a'�,
GOVERNOR
WAYNE MCDEVIrr Ray Vallecillo
SECRETARY 178 PUrlfoy Farm Rd
Beaufort, N.C. 28516
ROGER N. SCHECTER Dear Mr. Vallecillo:
DIRECTOR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF COASTAL MANAGEMENT
April 30, 1998
Attached is a Certificate of Exemption From Requiring a CAMA Permit to construct
a pier at Davis Bay Subdivision in Beaufort, N.C.
In order to validate this permit, please sign all three (3) copies as indicated. Retain
the yellow copy and the attached regulation (7K .0203) for your files and return the blue
and green signed copies to us in the enclosed, self-addressed envelope.
Your early attention to this matter would be appreciated.
COP/rcb
Enclosures
Sincerely,
Charles O. Pigott
Coastal Management Representative
MOREHEAD CITY OFFICE
HESTRON PLAZA II 151—B HIGHWAY 24 MOREHEAD CITY NC 28557
PHONE [phone] FAX [phone]
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