General Permits (6573)

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Y 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 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: ) I
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J
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.
LLL
41
Applicaht's signature
CAMA Off icial's'signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

- NCDENR
JAMES B. HUNTJR. '-.
_
'--GOVERNOR
WAYNE MCDEVITT
Quinton & Ann Williams
SECRETARY
200 Williams Ridge Rd
#�
t
Newport, N.C. 28570
F
R06BR+N.SCHECTER ..,-
DIRECTOR
Dear Quinton & Ann.
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF COASTAL MANAGEMENT
July 2, 1998
Attached is a Certificate of Exemption From Requiring a CAMA Permit to construct
two T-heads on an existing dock on your property at Hull Swamp Creek, in Newport .
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.
TB/rcb
Enclosures
Sincerely,
Tere Barrett
Coastal Management Representative
MOREHEAD CITY OFFICE
HESTRON PLAZA II 151-B HIGHWAY 24 MOREHEAD CITY NC 28557
PHONE [phone] FAX [phone]
AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED{1 Oq POST -CONSUMER PAPER

ADJACENT RIPARIAN PROPERTY OWNER STATEMEENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to qmf-w-16A' ,- /-9iv;,l ; s
(Name of Property Owner)
property located at A 61 Y1'1A tP C
(Lot, Block, Road, etc.)
on in Z Cl�I�T-y t 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. I understand that a 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.
tr I do wish to waive that setback requirement.
-------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
SG,,A /' C ta
rxy Y y
Q y Y Y YY
Y y X Y Y J
yyyyy
Si
i
Print or Type N e
0 Wk
Telephone Number
Date: '�V va- ai , � CA� 4

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to U n v I � Nnl 161i'01 ams's
(Name of Property Owner)
property located at
Gt l'Yl
(Lot,
, Road, etc.)
on Ur I ver in / V P, W i2vi-4 ! - d r + ae-1- , N.C.
aterbody) (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. I understand that a pier/mooring
pilings/boatliftiboathouse 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 DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
Print or Type N i e
-�
Telephone Number
Date: 0�01A,p �� / l—