General Permits (8131)

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-� CERTIFICATION OF E�I�N� �
T � FROM REQUIRING A CAMA PERMI 1 o 1092
as authorized by the State of North Carolina, 0
Department of Environment, Health, and Natural Resources s es ommission
in an area of environmental concern pursuant to 15 NCAC S�ir1(+.(?'zCTT3'•"""'~
Applicant Name w I � i a m , egbo u'J Phone Number
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.
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 maybe necessary
to continue this certification.
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
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.
i
Applicant's signature
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

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State of North Carolina
Department of Environment, Health, and Natural Resources
Division of Coastal Management
3411 Arendell Street • Morehead City, North Carolina 28557
James G. Martin, Governor Roger N. Schecter
William W. Cobey, Jr., Secretary Director
February 14, 1992
Mr. William Osterhoute
40 Oakridge West Drive
St. Peters, MO 62376
Dear Mr. Osterhoute:
Attached is a Certificate of Exemption From Requiring a CAMA
Permit to construct a bulkhead and pier.
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.
WDN/dh
Enclosures
Sincerely,
s�W. David Noble
Field Representative
P.O. Box 769, Morehead City, North Carolina 28557 Telephone [phone]
An Equal Opportunity Affirmative Action Employer

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to WILLIAM OSTERHUTE
property located at LOT # 9, GOOD WINDS SUBDIVISION
(lot,,lock. .road, etc .
oja GREENS CREEK near ORIENTAL
(body of water) (town)
North Carolina in Pamlico County. The proposal has been described to me as
shown below; a developmE:rit, a e- revetment, and the proposed
(circ _ - one)
location, and I have no objections to the proposal. I understand that if
-Lhe development is a pier, it must be set back a minimum distance of 15 feet
from my area of ripa:ria;i access unless waived by me. I tt wish to
(circle one)
waive that set back requirement.
Description and/or drawiri,g of proposed development. (to be filled in. by
individual proposing a,Qiopment) INDICATE THE SIZE AND LOCATION OF TIME
STRUCTURE AND THE DIO"TANCE BETWEEN EACH PROPERTY LINE AND WATER.
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(Original must be retained in the Inspection Department)
DATE ,�_ _ 9 �/
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SIGNATURE
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NAME, PLEASE PRINT

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to WILLIAM OSTERHAUTE
pCoverty located at LOT # 9. GOOD WINDS SUBDIVISION
(lot, block. road. etc.) GREENS CREEK near ORIENTAL ,
(body of water) (town)
North Carolina in Pamlico County. The proposal has been described to me as
shown below; a development, a pier/bulkhead/revetment, and the proposed
(circle one)
location, and I have no objections to the proposal. I understand that if
the development is a pion, it must be set back a minimum distance of 15 feet
from my area of riparian Access unless waived by me. I dodo not wish to
(circle one)
waive that set back raqui .rement .
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Description and/or drawing of proposed development. (to be filled in by
individual proposing development) INDICATE THE SIZE AND LOCATION OF THE
STRUCTURE AND THE DISTANCE BETI;EEN EACH PROPERTY LINE, AND WATER.
t �� -�
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(Original must be retained in the Inspection Department)
DATE_���
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