General Permits (6733)

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
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.
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.
Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assumption that the, lApplicant's signature
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
CAMA Official's signature
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.
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

Ernst L. Hayman
Pearl R. Hayman
,P.O. Box 0147
Beaufort, NC 28516-0147
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to �-/PINT 1— Mj� Q/,^poi 's
(Name of Property Owner)
property located at �-o; ;20 A&-,&ufc� f Nr�P �6—(oroe
(Lot, Block, Road, etc.)
on 1'T �, �-> > in � p AR el- , N.C.
(Waterbody) (Town an 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)
PRAWlu& .6rAr hep ��� /joj t AA),',
Af'PROX 1ih �� l3cJ 1 �a� I—F/00 f 6NP/NG—
Sign ur
r re !/►S
Print ortype Name
2 Jg _ 7g2.- 7 fo
Telephone Number
Date: // 4/ /99

Ernst L. Hayman
Pear! R. Hayman
P.O. Box 0147
Beaufort, NC 28516-0147
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to r 'RPST A. &J/Y140 's
(Name of Property Owner)
property located at I-o i ;20 sjpE 6.ki Agwo)<111 L' k"W 1
(Lot, Block, Road, etc.)
on; ,�RV15YSMlT�J Ayy&i0�4) in Z= a C-�-Vq .RET , N.C.
(Waterbody) (Town an 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)
pRAw/u.,,,- ArAchep f57oR NoC)�t Akp
�PPR o.X 1 M A% $il-4 6AP �'D,S1 I 1 b,4 Pep P/NG--
�,CA 'y1 A ` '& PPP -OVAL
Print yTor pe Name
-Z r2-) z--z- � 4t
Telephone Number
Date: //— c:.,:, / ` `:/`

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Ernst L. Hayman
Pearl R. Hayman
P.O. Box 0147
- ' C 28516-0147
5 72003' 04" kl
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tvo: 11-19a-3-,
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T CO. N.C.
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SURVEYED by
POWELL SURVEYInG COMPANY
P.n. aox 616 6EAUFDA7 NC 285t6