General Permits (7256)

CERTIFICAT PTION�
FROM REQUIRING AA6VJn%Tas authorized by the State of NorthartS
Department of Environment, He 1 al Res. ur he Coastal Res r #mission
in an area of environmental con 1�A apter 7K .0203.
Applicant Name C t-
Address
City
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.
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.
j SKETCH (SCALE: )
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
4evelopment.
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
C
rJ"
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

State of North Carolina
Department of Environment,
Health and Natural Resources • •
Division of Coastal Management �I
James B. Hunt, Jr., Governor p R
Jonathan B. Howes, Secretory I C
Roger N. Schecter, Director
September 13, 1994
Mr. Charles Sawyer
P.O. Box 251
Marshallberg, NC 28553
Dear Mr. Sawyer:
Attached is a Certificate of Exemption From Requiring a CAMA Permit to construct a
pier off SR1346 and Star Church Road, in Marshallberg, on Sleepy Creek, Carteret County,
NC.
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.
Sincerely,
Charles O. Pigott
Field Representative
COP/dh
Enclosures
P.O. Box 769, 3441 Arendell St., Morehead City, North Carolina 28557 Courier # 11-12-09
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that -I own property adjacent to
' s property
Name J
located at _ .S"�'A/2 614pen P on
ff (Lot, Block, Road, etc.)
�IF2iJtl no�� in nn \ , C',�P �Zy�,C� , N.C.
"a+ er Roily) Town and/or Co my)
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 must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
do no wish to waive that 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)
4-
,F71
1J Y e V E 1 2
y Signa ure
Name
5-D pf
Phone N er
0

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that -I own property adjacent to
�� �catr1 < osWQ 1) Is property
Name-1
located at on
t� (Lot, Block, Road, etc.)
in �` �u,� \0 ��h�c� N.C.
(`r,'ater Body; (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 must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
I do not wish to waive that setback requirement.
V I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (TO BE
FILLED IN By INDIVIDUAL PROPOSING DEVELOPMENT)
QF 17T,77-`�
•..� - SEP i 1994
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gnature
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Name
Phone Number