General Permits (7401)

CERTIFICATION OF EXEMPTION.-
FROM REQUIRING A CAMA PERMIT OCT 1 91 2000]� 1 la -
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. `'A'''''`-''' ` {
Applicant Name Phone Number' -'• ���v '�
Address
City State Zip
Project Location (County, State Road, Water Body, etc.)
COX. ;x-7
Type and Dimensions of Project Q0 �a- ax_v,
,..1,4
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.
C
SKETCH (SCALE:
d-1 " 1" .
LLX
Your project is subject to the NC Division
of Water Quality Neuse River Buffer Rules
due to its location within the Neuse Basin.
Please contact Deborah Sawyer at
252-946-6481.
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.
r k rj;I N.
___1/
%1_3p�ficants signature
CAMA Official's signature-,.)
Issuing date
Expiration date
V�
Attachment: 15 North Carolina Administrative Code 7K .0203

r 'gig "7
7
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF COASTAL MANAGEMENT
October 10, 2000
T JR.
- Carl Jones
5901 Fix It Shop Road
Wake Forest, NC 27587
Dear Mr. Jones:
Attached is a Certificate of Exemption From Requiring a CAMA Permit to install 90 ft. of
rock along existing rock footprint and above NWL backfill and stabilize disturbed area.
Disturbance zone limited to 20 ft.
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,
A. M. Scott Jones
Coastal Management Representative
MSJ/src
Enclosures
tN'AM Sp.1LA `�'
MDR EHEAD CITY OFFICE
HESTRON PLAZA II, 151-B HIGHWAY 24, MOREHEAD CITY NC 28557
PHONE: 2S2-808-2808 FAX: [phone]
AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED / 10% POST -CONSUMER PAPER
DENR TOLL FREE HOTLINE: [phone]

OCT. 9. 2000 12;OOPM 'R07ECTiVE L:=L 10, 2979 P, 1
�• LAVER SET
FAX
DATE: / O .
COMPANY:
FRO - -x T - «11) '7
NO. PAGES (J Q /
fttecMk
Proteetive Life buunau Congmmy
FlammW ImWtaftw laawmm Dhidm
Iwo Mom Dkiz 30"t
R&Wgk PI" CwsU" 276ZW 00
(911h 7f1460
FAX (PM 791-Ml

OCT. 9.2000 12:OOPM PROTECTIVE LIFE NO.2979 P. 2
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to o' is
(Name of Pr erty Owner)
property located at P49 7A2t% — J
' (Lot, Block, Road, etc.)
On ' +tL� •E're— , in 1 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 07
(To be filled in by individual proposing development) AIP
DPq
Sienature
_4&� Z.
Print or Type Name
Telephone Number
Date:
-29-

OCT, 9.2000 12:OOPM PROTECTIVE LIFE N0.2979 P. 3
ADJACENT RIPARIAN PROPERTY OWNER STATEVZENT
I hereby certify that I own property adjacent to J a .ES -s
(Name of Pr6perty Owner)
property located at 2-4 5 `A21x o / 4 ZZ ,
(Lot, Block, Road, etc.)
on Si)wtr z -)V")y 2�p� in 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) ADD We.;,j
nip
-91nd5 t/.t�24J o
0479
O U
u✓Ct
4
�1\
Signature
Print or Type Name
9 4 ) EGG �98 0 '
Telephone Number
-29-