General Permits (6889)

CERTIFICATION OF EXEMP '104
0021999
a
F
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, COAST�t� dVt4fv:an _MENT
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. aV ; ;7 � ��� 7
a
Applicant Name Phone Number 6_ v i 3
Address _27 t- Sld 79k- 7 S)
City State Zip
Project Location (County, State Road, Water Body, etc.) s
Type and Dimensions of Project Q C��
4 ��tR a 1 C { cC,,Wires
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.
I SKETCH (SCALE: ) I
h
E~ Pf^ �J�i •f ��'^e"y S �9•
21.
;r+kt Pt T.
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.
i
Applicant's s
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

t
ADJACENT RIPARIAN PROPERTY ONN7\TER STAMNIENT
(FOR A PIEPUMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to l�l s's
(Name of Property Owner)
`
property located at Lo% /"/.�' �a�?B. �,•-/G� - 7�Ia'/O,/7.4�•- 32
(Lot, Block, Road, etc.)
on in lilwwwlaamv-cmlei ��%�•v7 , 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/boatliftlboathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
1'1�t/ I do not wish to waive the setback requirement.
I d2 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
crzFr�l i��.
'V
a= Slo/�
PROPOSE[
'/1ET,=i5LC'7 timAl
LiiA/E y
Signature
1J �/ F F�
!60K-
Telephone Print or Type NameNumber
Date:, % S

ADJACENT RIPARIAN PROPERTY ONVNTER STATENIENT
(FOR A PIERAVOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 10 N� ' � 's
/ p (Name of Property Owner)
property located at Lo7.4V A�� */j�:2 - AY/O-/?ff -/-32 ,
(Lot, Block, Road, etc.)
on _ �Uf'lM��/� G� , in ,�iE ,,�v%w�.wr,��. L�JLa�.%y , 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 obiections to his proposal. I understand that a pier/mooring
pilings/boatliftlboathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
C ' I dg not wish to waive the setback requirement.
I dg wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual sing development)
_ proposing , -7
crzFr.+l i°r -
,�r� w/cam
-- - ... moo•:, 4- ��' -- ---- - -
PROPOSE
{ ' Signa re
6 Pk
Print or Type NameDOEK- f7e
Telephone Number
Date: �i -' 9 cJ

w
oc
UQ
pOAP
CREEK
100
5 9-6s.01= 10 "
�.. s
fi,,7.02-
10i
n wtp
lob 4�
R1 3 lt�
O ;'L
I S jLAG
� I
'a• nRAINAG� I I 1 r �~c �\
-� 5•z3" �
75I AMA SET HAC t<
zV
�E-N80P
AREA OF \W 0 RK \ ''�` ' " L'�'�
r� NOTES:
CUM M /A/S CREEK % �k- MAP BOOK 28 P6EI&2-
V- TAX PARCELJ'v� 10-124•1-32
fA
�d, ��EVA� lo►�
E.I.P.
WF RRERgRER FOR
CHARLES W 0 RUTH NOVEMBER
LGI— ----,2 QCI I^IS L."77:DI IG tip 'IA�{U�/,•rf'%
MERRIMOAl TOWIVSHIP,CARTERET CO Al
JULY 15, 1992 SGALE-/1,610'
y
7D. JVI�YGTCU DT
POWELL SURVEYING COMP8N
i P n RnX r 147, PrA i ICa OT Al r, WC
fn

MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERWI'TEE' S NAME: G h a ,7/ o c -7 PERMIT # -Q- �-.o 41 p f / e .1,
LOCATION: C �! -, f `�Q - (�- C4 ce FIELD REP. C , O. AI _
1jOe% -I.O.1 14. C'
PHONE:
1)
2)
3)
DATE REPORTEDLY COMPLETE: 1 a- 6 - F f
Do the measured dimensions of the development differ from those indicated in the permit and workplat?
YESI@-[circle one].
COMMENT:
SEDIMENTATION ION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized
all disturbed areas?O;S'�Ircle one]
COMMENT:
FUTURE MONITOR & ENFORCEMENT ACTION: Is further investigation or enforcement
action needed? Y circle one].
COMMENT: