019-97_Stephon, Carlie & Marie_19970612

-Y—
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT ���
as authorized by the Stale of North Carolina,
Oepartmont of Environmant. Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K 0203.
App4cani Name �h A� 11, Q �WI Aw1 Q S � h o_� Phone Number / So
Addtess -5 C ,nt.+t,' ! u i LL Are- D r u C
Ci stile — N C Z•t 2.
Project Locallon ( unty, St�te Road, Water Bndv, etc.) C
1 ype and Dimensions or Project TaTig L Lr2=SyA
The proposed project to be located and constructed as described This c—tilication of exemption from requiring a CAMA
above is hereby certified as exempt from the CAMA permit to. valid for 90 days from the date of issuance. Following rr
quiromont pursuant to 15 NCAC 7K .0203. Thts exemption to a re-examination of the project and project site maybe n
CAMA permit requirements does not•alleviate the necessity of to continue this certification.
your obtaining any other Stale. Federal, or Local authorization.
1
SKETCH
Sr; (SCALE:
UP
%W l
W
J `
�J !
L � �
t
ice° �— .}-
wpOL "we _r
Any person who proceeds with a development without the con-
sent of a CAMA offtaef under the mistaken assumption that the
development is exempted, will be in violation of the CAMA 4 there
is a Subsequent dotormination that a permit was required for the
development.
The applicant certifios by signing this exemption that (1) the ap-
plicant has road and will abide by the conditions of this exomp-
Ian, and (2) a written statement has been obtained from adjacent
Landowners Certifying that they have no objections to the
Proposed work.
Applicant's ionatufe ,
CAU 011ic al' s rtatur
Issuing dale
6 -// - F7
Expiration dale

CENTRAL PERMIT OFFICE OF
1 COURTNOUSC soUARC
- --.-�' 9EAUroRT. r4. C 283a. eae
7za•aaas
CAxTCxCT C=Jmry CONM).Smac •W�OHcf, yO�+tt "C'M cl4CT*1CA4 ftywsu.G, �CCN&0"CAl
ADJACENT RIPaRI�N PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to:
_°*R Ln 3 M a fin=
property located at: 3 ^ CUt ►AvVVt,&( G.
near (water body) �1(�/� ��(! (121 5X' V'Aoq-t,,
.in (county). CVO k
The applicant described to me s shown below,
he/she is proposing in th t loca ion and: /
I have no objections to t is prop sal
I do have objections.to .is prop s
the
Oescription and/or awing of�sed development:
�celopbent
purer
Name:
Phone Number: 7

ME
- �_.•. I + RIPARIAN PROPERTY OWNER STAMan
I hereby certify that I own property adjacent to `
�s
(Nave oWro;Zy ORuer)
propCriy located at te.,T 3 5'
Lot, Bluck, Road, etc,)
(Wattrbo y) � (Town au/or County)� � N.C.
He has described to me as shown below, the development he is proposing at that location,
and, I have no olbjec6on9 to his proposal.
A--------- --------------------- -,r,c _----------- -------------------------------------------------
DESCRIPTION /OR D C OF PROPOSED DEVELOPAENT
(To be, f i ed to by d&Nual proposing development)
,
------------------- '=------------ .1
�4ZT_1
LQt�l
Cud
O(q- 9 7
LO-C 2A
��.
Signature
Pint or Type Name
Telephone Number
Date; 2-, \ t_'1 • et
ttzrcc- Fnl,-� FAX IF
- -,---- Md 08Sq -'di =`hJI �tJI!.tdi• d. 4! d J:QI G :JT Wit, _LiT =d':I1