General Permits (7818)

P"
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT �,ug
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Res o rces Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7,/.020
Applicant Name
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 obtaininq anv 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.
L --)
Any person who proceeds with a development without the con
sent of a CAMA official under the mistaken assumption that the Applicant's signature +
development is exempted, will be in violation of the CAMA if there ,
is a subsequent determination that a permit was required for the
development. CAMA Official's signature
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) awritten statement has been obtained from adjacent
landowners certifying that they have no objections to the
proposed work.
ng date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

Jan-05 _ruction 252 504 3500 P.01
Fax Cover Sheet
RATE: JANUARY 5,2000
TO: CAMA
Terry Barrett
FROM:AMANLA LEWIS
RE:
CC:
Number of pages including cover sheet: 3
TIME: 3:50 PM
FAX: [phone]
PHONE: [phone]
FAX: [phone]
Message:
Note: The house now -AV be placed 70' for Taylors Creels.

Jan-05-00 03:49P Creekside Construction 252 504 3500 P.02
CAP%ftncr C04�NTr CQVIRT►«Qust
CouRrr+oust SQUA141E
O AWFO RT. N. C. 285 16- 1 So@
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ADJACENT RIM AN PROPERTY OWNER STATEMENT
i hereby certify that i own progeny ad*ent to- 1-a, jt, �r t7al
property located at 1 _r r�-.,''�lz c �', �s�. + , n= (water
body) ' in (county)
The appl€carat described to axe u shown below, the development he/she is proposing M" that location and:
I have no obger6ons to this prgmsai V"
I do havt objettio ns to this proposal
Phone NumberDate

Jan-05-00 03:51P Creekside Construction 252 504 3500 P_03
CENTRAL PERMIT O FFiCE «F
e
COURTHOUSE SQUARQ
REAUP`ONT. Pt. C. 21151 8-1 aft$
728.6345
iui4•0I0#G0 F QW.0 HOMCS. tWtCTXkCa►*L rLUtm*W, NKCMAWCAt.
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hcre'by certify that'I own prop" adjacent to
prop" located at a�S� � -� ����� a'��r ��: t'.s�u.�s� r � . near (water
body) in (county):✓ -
The appficant daesmibed to me as shown below, the developmm Wshe is proposing in that lo"tim and:
r
I have no objections to this proposai __ f
I do have objections to this proposal
e a a.r .7a .h a4" a it 1 a FTA-4 yl a. y &-A ., -T 11 tf t ; ;
'�-* Ott 1 "r 9 ',1 "
I �.G.f C� C",t,,,;'C�.. � Y'" �� � �� wq� t"� rJ w;'S �- 0. r� c\ ,� e � �c�.[. �e � . �•L.. 'ia-� e � {�._.�--s-� j.
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Signature
Name:
Phone Number
Date