The URL can be used to link to this page

Home My WebLink AboutGeneral Permits (7114)12 CERTIFICATION OF EXEMPTION FROM REQUIRING A CAMA PERMIT .�•�.�....,. /ter^'• J �'7 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 r' Address O City Project Location (County, State Road, Water Body, etc.) Fype 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. Phone Number State 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. SKETCH (SCALE: ) I�' 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 ,Of -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 signature /) , CAMA Official's signature Issuing date Expiration date Attachment: 15 North Carolina Administrative Code 7K .0203 M � r c nu- Lk&ms d'"� ENVIRONMENTAL HEALTH DIVISION CARTERET COUNTY HEALTH DEPARTMENT G.S. 13OA-336 BEAUFORT, NC 28516 (919) 728-8499 IMPROVEMENT PERMIT VALIr FOR 60 MONTHS Subject to revocation if site plans or if 7 site is altered or intended use is changed. BATE / c. ELECTRICAL PERMIT REQUIRED: Yres(�).,No 04 OPERATIONS PERMIT REQUIRED:YNo(. 'J u� ADDRESS: PROPERTY LOCATION: �—L f SUBDIVISION: LOT: BLOCK: TYPE STRUCTURE: 11h,' `r NO. BATHS: �? NO. BEDROOMS: NO. PEOPLE: DESIGN FLOW: ' '� �' GARBAGE GRINDER: Yes( No( ) SEPTIC TANK: GAL. PUMP TANK: GAL. NO. LINES:! �' `'� ;� ' 10 WIDTH: TOTAL LENGTH: / i 0 FT. TOTAL: ii `' SQ. FT. WATER SOURCE:ya;;5/;{�,.;;r HORIZONTAL DISTANCE FROM WELL: SITE MODIFIED: Yes ( ) No ( (,�j DRAINAGE REQUIREMENTS: EASEMENT REQUIRED: 'z Yes No /�' `/fir FT. DRAINAGE MAINTENANCE REQ.: Surface ( ) Sub -surface( ) 6782 M.E. CLASSIFICATION `Construction ❑ Repair d,t(zkt— AV��FDExisting System 'SYSTEM SHALL NOT BE INSTALLED UNDER WET CONDITIONS 'Trench bottom depth to be no deeper than naturally occurring surface. , I/ vt'.0 M MAINTAIN MINIMUM 10' FROM WATER LINE - (/V COMMENTS: : c �. t 'I ^ ' ) r7,4-/ 'Prior to any change in system layout, approval must be o4tained from Health Department. NOTICE: Construction must comply with all state and local regula- tions. Do not install well until well site has been approved. Do not T"� �� (D•�(,/ ,� cover any portion of the system until approved on inspection. NOTICE: Beware much property in Carteret County is subject to Weiland Regulations and properties containing wetlands should - receive approval from U.S. Army Corp of Engineers prior to develop- ent /Y" "ADDITIONAL RE IR ME F D U E NTS N BACK O PERMIT O IMPROVEM TS P. Rl;� VYVA, F� ENVIRONMENTAL H ALTH SPECIALIST Attachment "A" i � r139 PEE 55.19 I oti 60 b �• ACTU s �' •� PROPERTY •* vo N � . N VCo t �, (►� -t, � tv 22 � 4 I N/F NAN CY v DELL, SHAT O -� NIF GOSPEL i fv r' � MCROAGFi UM r Co rt� M 00 , r L , ,� iso 'Se O<<k Yy N%E D OUGLhS MARTIN RED'. PLAT BY : JAMES C. SIMMON DATED JUNE 2, ,1 f I I 1 rj l t i 1 f APPLICATION FOR CAMA p' MINOR DEVELOPMENT PERMIT In 1974, the North Carolina General Assembly passed the Coastal Area Management Act and set the stage for guiding development in the fragile and productive areas which border the state's sounds and oceanfront. Along with requiring special care by those who build and develop, the General Assembly directed the Coastal Resources Commission (CRC) to implement clear regula- tions which minimize the burden on the applicant. This application for a minor development permit under CAMA is part of the Commission's effort to meet the spirit and intent of the General Assembly. It has been designed to be straightforward and require no more time or effort necessary from the applicant. Please go over this folder with the Local Permit Officer (LPO) for the locality in which you plan to build to be certain that you understand what information he or she needs. Under CAMA regulations, the minor permit is to be issued within 25 days once a complete application is in hand. Often less time is needed if the project is simple. The process generally takes about 18 days. You can speed the approval process by making certain that your application is complete and signed, that your drawing meets the specifications given inside and that your application fee is attached. Other permits are sometimes required for development in the coastal area. While these are not CAMA-related, we urge you to check with the Local Permit Officer to determine which of these you may need. A listing is included on page 2 of this folder. We appreciate your cooperation with the North Carolina Coastal Management Program and your willingness to build in a way which protects the resources of our beautiful and productive coast. Coastal Resources Commission Division of Coastal Management Locality Permit Number GENERAL INFORMATION LAND OWNER Name LQbrl a V . Miag0L,1 �3"r. i" ,::, .6k I P Address P o. o ;LC l C3 q City ly et"'42 c r * State N— Zip Phone a'�3 - ;� (.�:)-q, AUTHORIZED AGENT ' I 1 Name S .. T. mc�rm; I la.,, SL" [��5 ��-.{ UC-TF f�"iJ , Address' . 0, I,, -'C s- j k City 6 + I ra r, �' r T, t Ask State #V C Zip �S Phone 2 V 7— . J 83_Y LOCATION OF PROJECT ro A 0— (If not oceanfront, is waterbody natural or manmade?) h ,- DESCRIPTION OF PROJECT .S +o oni. /1 (- a: C b S G t1 l!" , 1, n.. 1 1 .� '44, ✓a rr3r' kA i'tJ D't !1 100le. AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION (To be filled in by the Local Permit Officer prior to completing application.) OceanHazard Estuarine Shoreline ORW Shoreline Other PROPOSED USE ✓residential Commercial/Industrial Other SIZE OF BUILDING IN SQUARE FEET ;),j q k Size of other impervious or built upon surfaces (such as driveways, etc.) within 75 feet of the shoreline (575 feet of an ORW shoreline) a � Y SIZE OF SITE IN SQUARE FEET 3 E 8 d', I.) - OTHER PERMITS MAY BE REQUIRED ... The activity which you are planning may require permits other than the CAMA minor permit you are applying for here. As a service we have com- plied a listing of the kinds of permits which might be required. We suggest that you check over this list with your Local Permit Officer to determine which, if any, of these may apply to your project. This is not a requirement of LAMA, only a sugges- tion to help you complete your project as quickly as possible. Zoning, Drinking Water Well, Septic Tank (or other sanitary waste treatment system), Burning, Electri- cal, Plumbing, Heating and Air Conditioning, In- sulation and Energy Conservation, FIA Certifica- tion, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, Others: STATEMENT OF OWNERSHIP I, the undersigned, an applicant for a CAMA minor development permit, begin either the owner of property in an area of environmental concern or a person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person listed as landowner on this application has a sig- nificant interest in the real property described therein. This interest can be described as follows: (check one) an owner of record title, Title is vested in iI ` V + Jor x.e;n_§ee Deed Book page '-'I 12 in the C 1�) l2 fe, 01- County Registry of D@Fds. an owner by virtue of inheritance. Applicant is an heir to the estate of probate was in County. if other interest, such as written contact or lease, explain below or use a separate sheet and attach to this application. NOTIFICATION OF ADJACENT PROPERTY OWNERS I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit. (Name) (Address) (1) /U�r,cv LL�� %�c�i�� e KK .a570 (2) y (3) (4) FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS: I acknowledge that the land owner is aware that the proposed development is planned for an area which may be susceptible to erosion and/or flooding. I acknowledge that the local permit officer has explained to me the particular hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofing techniques. PERMISSION TO ENTER ON LAND I furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer and his agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. This application includes: general information (this form), a site drawing as described on the back of this ap- plication, the ownership statement, the AEC hazard notice where necessary, a check for $50.00 made payable to the locality, and any information as may be provided orally by the applicant. The details of the application as described by these sources are incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation of any permit. Any person developing in an AEC without a per- mit is subject to civil, criminal and administrative action. This the lt�:day of '19q_ Land owner or -person authorized to ac s his agent for purposes of filing a CAMA permit application. 9 r I I SITE DRAWING/APPLICATION CHECKLIST Please make sure your site drawing includes the following information required for a CAMA minor develop- ment permit. The drawing may be simple and not necessarily to scale. The Local Permit Officer will help you, if requested. PHYSICAL DIMENSIONS label roads label highways right of ways label local setback lines label any and all structures and driveways currently existing on property PHYSICAL CHARACTERISTICS draw and label mean high water mark (MHW) draw location of septic tank or filter field If you will be working in the ocean hazard area: draw and label dune ridges (note height) draw and label toe of dune identify and locate first line of stable vegetation draw and label setback line under CAMA draw and label topographical features (optional) If you will be working in an estuarine shoreline area: draw and label landward limit of AEC describe terrain (slope) DEVELOPMENT PLANS draw and label areas that will be disturbed if a house is to be placed on lot, describe location of house note size of piling and depth to be placed in ground draw and label all areas to be paved or graveled describe composition of surface note and list fully all trees and vegetation to be removed or relocated show landscaping NOTE TO APPLICANT Have you: *completed all blanks and/or indicated if not applicable? *notified and listed adjacent property owners? *included your site drawing? *signed both application and statement of ownership? *enclosed the $50.00 fee? *completed an AEC Hazard Notice, if necessary? FOR STAFF USE Site Notice Posted Final Inspection Fee Received Site Inspections Date of Action: Issued Exempted Denied Appeal Deadline (20 days)