General Permits (8136)

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT J C'ico� CPI
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources mission
in an
area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name Phone Number
Address
City Stat Zip
Project Location (County, State Road, Water Body, et c��•
Type and Dimensions of Project ' �.> t- �.� ti PP L
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.
SKETCH `: - % (SCALE: )
— ---- ,{
i
I
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
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

64
s+\N A
One,
a
,'J t I itVvl'
Sr4ND LINT
onb 1 vim- -
�J.X40

1
3 7�'
T u (�,o w D
O
/ r(
` l-6 —
- - Co�C HES c Fr-�C--._._.__
ri
3 If
T O -q o -4
L07: 17

,lv�e'Is e
Ivey
cocov-
ACREAGE CHART
LOT
ACRES
LOT
ACRES
LOT
ACRES
LOT
ACRES
LOT
ACRES
1
1.26
8
0.88
15
0.93
22
1.09
11A
0.62
2
1.27
9
0.52
16
0.94
23
1.72
12A
0.45
3
1.10
10
1.64
17
0.96
24
2.16
21A
0.50
4
1.14
11
6.45
is
0.96
3A
0.22
22A
0.38
5
1.10
12
1.08
19
0.98
8A
0.26
23A
0.45
6
1.19
13
0.80
20
1.17
9A
0.36
7
1.23
14
0.88
21
1.06
10A
0.47
VICINITY MAP
COACHES
P
%-r
ire River
,1.
ti
WEvER -."EEL's=-

P 066 509. 206
Receipt for
Certified Mail
No Insurance Coverage Provided
Do not use for International Mail
vOST45ERVriCF
(See Reverse)
Sem io
V
Sta2 r„ � 4 C L r rn
P 0Slat t 71P Ce a,
ff N, Q
Postage
Ce,Wled Fee
Speco� Dehvery Fec
Restricted Deovery Fee
Return Receipt Showing
C,
to Whom & Dale Detive-4
N
Return Rece,pi Shc—n to Wnoq�
e
Date, acid nddr
TOTfit Pos
n�
$
O&
Fees O�
y�
Postmar IVJ ate00 2�
M
t
t-
LL
V Se
CL

I II II I
m SENDER:
I also wish to receive the
Official Business
o • Complete items 1 and/or 2 for additional services.
w • Complete items 3, and 4a & b.
following services (for an extra
PENALTY FOR PRIVATE
y • Print your name and address on the reverse of this form so that we can feel:
USE TO AVOID PAYMENT
OF POSTAGE, $300
m return this card to you.
> • Attach this form to the front of the mailpiece, or on the back if
space 1. El Addressee's Address
y
does not permit.
G
L • Write "Return Receipt Requested" on the mailpiece below the article
number. 2 ElRestricted Delivery
r • The Return Receipt will show to whom the article was delivered and
the date
Consult postmaster for fee.
0
c delivered.
3. Article Addressed to:
4a. Ar ' le Number
Print your �a e, address and ZIP Code here
_ I E Y ^fn ` 0
c a kJ o w c 1 I
196
4b. Service Type
Registered El insured
�
cm
• ����1
u
WZ r<, I �'j'( 1_ /4J�1r,l, '(�
Certified ❑COD
❑Express Mail ❑ Return Receipt for
c
cc
Merchandise
c
c��
� N�
°a = Y'a°g4�1firvel
7. oivery f Del
oZc 5. Signat ddress
A dressee's Address (Only if reclues ed
and fee is paid)
%
_
W
cc 6. Signature (Agent)
~
o
0
N PS Form 3811, December 1991 :': U.S.G.P.O.:1992-307-530 DOMESTIC RETURN RECEIPT

ADJACENT RIPARIAN LANDOWNERS STATEMENT
General Statute 113-229 requires that riparian landowners
with property adjoining a proposed excavation and/or.fill project
be given thirty (30) days in which to comment on the project.
This form allows the adjacent riparian landowner to express
either: (1) That he objects to the project; or, (2) That he does
not object and desires to waive his right to the 30-day period so
that the processing of the application can progress more rapidly.
Of course, the adjacent riparian landowner need not sign this
form at al if he so chooses.
I, ,` (� �L , am an adjacent
riparian prop rty owner and have seen a copy of the application
submitted by Q Y1 -se, L 0 7- -4 1 6 dated
19 , wherein said applicant
.� PP requests a
permit to excavate, fill, or otherwise alter the land or water
adjacent to my property.
I have no objection to the project as presently proposed
and hereby waive that right of objection as provided in
General Statute 113-229.
I'have objections to the project as presently proposed
and comments are attached.
Signat e of Adjacent
Ripari Landowner
DATE • "
FORWARD COMMENTS TO:
Division of Coastal Management
P. O. Box 27687
Raleigh, NC 27611
I� ��,I Y �ul�C�� c�c�'' Lo'� 16

To Whom it May Concern
We have no problem with Allen Rose building a bulkhead for
his lot, number 16, at Coaches Creek.
Leon Stuckenschmidt
Owner of Lot 17, Coaches Creek
110 Overview Lane
Cary, NC 27511
June 27, 1992
ql 9 3 33 y9 w
it � y6 7° sj,�i

1 ..�.
Ry:'

IF
.x
ail
1-
i I
41,

A
I
N � I
", 1