General Permits (8164)

Applicant Name,
Address Z0.
City
Project Location (Co
CERTIFICATION OF EXEMPTI6N 9�,
FROM REQUIRING A CAMA PERMIT
co
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 t 15 NCAC Subchapter 7K .0203.
Phone Numb',fD
ter Body, etc.) •-• o
#, Z_
State
!iN
I ype 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.
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;
v
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
*velopment.
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.
t.t
Applicant's signature
'CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

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STATEMENT OF OWNERSHIP
general
I, the undersigned, an applicant for a CAMA 4gbq9,r development permit, being either the owner of property in
an area of environmental concern or a person authorized to act as an agent for purposes of applying for a CAMA
minor development permit, certify that the person listed as landowner on this application has a significant interest
in the real property described therein. This interest can be described as follows: (check one)
X an owner of record title, Title is vested in Gerry T . Smith and Rebecca T _ Smith
Carteret
, see Deed Book , page in the
County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
; probate was in
County.
if other interest, such as written contract or lease, explain below or use a separate sheet
attached to this application.
r
C
NOTIFICATION OF ADJACENT PROPERTY OWNERS >
r
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that
I have given ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for
a CAMA permit.
(Name) (Address)
(1) C� kJ.cCi Q �� I
Ballou Enterprises, Inc.. P. O Box 900., Morehead ;t)z, N 28557
(2) Ballou Enterprises, Inc., Developer representing
—Sniit-h Rhnrac Nnmeawnerc p 0 900, �� r' i✓�-j- Ad-c;. 28557
(3) I
(4)
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE SHORELINE EROSION AREAS:
I acknowledge that the land owner is aware that the proposed development is planned for an area which may i
be susceptible to erosion and/or flooding. I acknowledge that the local permit officer has explained to me the
particular hazard problems associated with this lot. This explanation was accompanied by recommendations
concerning stabilization and flood -proofing techniques.
L
PERMISSION TO ENTER ON LAND 7
I furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer
and his agents to enter on the aforementioned lands in connection with evaluating information related to this
permit application.
This the 14 day of 'February— , 19 99.
Lana owner person author ed to act as his
`,r rurpose Vf filing a CAM application.

GENERAL PERMIT APPLICATION INFORMATION
APPLICANT'S NAME: Gerry T. Smith
(First) (Middle) (Last)
NA...TNG ADDRESS: 203 Fairview Drive
(PERMANENT)
Beaufort
TELEPHONE: WORK ( 919)
728-4935
CONTRACTOR'S NAME: T. D. E u r e C o n s t. Co.
STATE NC ZIP 28516
HOME ( 919 ) 728-4893
TELEPHONE NUMBER 728-4191
PROJECT LOCATION: N.C. Hwy. # SR # 1177 Road/Street Name River Bluff Road
Waterway Name Newport River County Carteret
Town Morehead Township Subdivision South Shores
PROJECT ACTIVITIES:
PIER: Total dimensions of pier from MHW to platform
(Length) (Width)
'T' or 'L'-head platform
(Length) (Width) (Number of Mooring Piles)
Water depth at end of pier
Br- . HOUSE/BOAT LIFT: Length
Number of Piles
Number of Mooring piles
Width
Water Depth
BULKHEAD: #1 Total length 130 Feet
Average distance waterward MHW none"
Maximum distance waterward MHW none
#2 Total length
Average distance waterward MHW
Maximum distance waterward MHW
RIPRAP: Total width length Base
g i from MHW
EXCAVATION: [MAINTENANCE 'ONLY']
Length Width Depth of Cut
Adjusted water depth on MLW Existing water depth(s)
Estimated Cubic Yards (length x width x depth/27)
Type of spoil: Sand Mud
Dragline Backhoe Hydraulic
OTHER STRUCTURES: