General Permits (7877)

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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
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
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.
`�DC - :,fir J1rl
Phone Number )) 4
State Zip r
This c(,,tification 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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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
CAMA Official's'signat'ure
i
.�
Issuing date i
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS1B0A7LIFT/BOATH0USE)
I hereby certify that I own property adjacent to Emily and David Weil ,
s
(Name of Property Owner)
property located at
on North River
(Waterbody)
610 Bronna Road
(Lot, Block, Road, etc.)
In Beaufort,
(Town and/or County)
N.C.
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/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
xx I do not wish to waive the setback requirement.
I do wish to waive that setback requirement. MAR 2000
--------- ---------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPNLE.NT:
(To be filled in by individual proposing development)
An 8' x 10' Deck at the end of a 12' Pier. The width of the pier
will not exceed 61. The pier will not be located closer than 35'
from any adjoining property line.
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&ANT
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Sig ture I' /
Print or Type Name
Telephone Number
Date: IAA 4. 'Yoov

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to Emily and David Weil ,
s
(Name of Property Owner)
property located at 610 Bronna Road
(Lot, Block, Road, etc.)
on North River Beaufort,
N.C.
(K'aterbody) ,
(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/mooring
pilings/boadift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access uruess waived by me.
iXX
- r
I do not wish to waive the setback requirement.j; I, !
MAR 1 0 2000
I do wish to waive that setback requirement. I
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by indii-idual proposing development)
&ANT
P"FeA 1
An 8' x 10' Deck at the end of a 12' Pier. The width of the pier
will not exceed 6'. The pier will not be located closer than 35'
from any adjoining property line.
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Print or Type Name
Telephone Number
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