General Permits (7378)

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CERTIFICATION OF EXEMPTION
„
FROM REQUIRING A CAMA PERMIT /!r ((u d/
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 1�x{cr P! l fv,- Jlt J,7.
Address A;,L 1Vtanni>'r'
City 4.
Project Location (County, State Road, Water Body, etc.
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State
Phone Number 251.2Y3.91fV
Type and Dimensions of Project P P« r f4,y' ah,,- 4' - etcl i•"f 4Fve
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 d r 5'.
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.
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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.
Applicant's signature
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CAMA Official's signature
Issuing date
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Expiration date
LC
Attachment: 15 North Carolina Administrative Code 7K .0203

MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMITTEE' S NAME: fa
ail
PERMIT # P `
LOCATION: 1io� Z
W��hu l�ru�C ,
S`�vF. Crpel� 14hailvL
FIELD REP. .S�agyp/
a-2 kiln ,�c
PHONE: 2Sz - 393. 01 V Y DATE REPORTEDLY COMPLETE:
1) Do the sured dimensions of the development differ from those indicated in the permit and workplat?
YES/11circle one].
COMMENT:
2) SEDIMENTATION OSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized
all disturbed areas? NO [circle one]
COMMENT:
3)
action needed? YES/1W J&cle one].
COMMENT:
: Is further investigation or enforcement

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1AN-12 2001
I hereby certify that I own property adjacent to pa-yon/ / "l • r OLZ� �2llS�Qe 's
(Name of Property OwnerEMENr
property located at �lll%�/f%�Q �jlt�pL�I�IS�Y)�CfJ7'o�- 53 h5 0 oQR 13
/ n ,Q (Lot, Block, Road, etc.)
on �/ le4QdK 1 � Ce/e , in &RWC 7 - �0��7" , 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
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Signature
Print or Type Name
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Telephone Number
Date: /aL"-?a /o v

Sent• -By: McLEAN REAL ESTATE; 252 393 2463; Jan-18-01 9:03; Page 2/2
ADJACENT RMARiAN PROPERTY OWNER STATEMENT
T hereby certify that I own property adjacent to s
(Name of Property Owner)
property located at (,1.1 r+ G ti u -rP,A e e._ Sub A IV ► s / o &l ,
(Lot, Block, Road, etc.)
on1L9�\,tQ (OAK ��ueP, ,in (-1 A -reee 1 0-ou-J N.C.
(Waterbody) (Town andlor County)
He has described to me as shown below, the development'he is proposing at that location,
and, I have no objections to This proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled is by individual proposing development)
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Print or Type >`(arne
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Telephone Number
Date: 0aJ� � -�- 2.0 0