Mallaney

v
plicant Name I
dress 31-Zcf
y 1
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 :0999;.
t-
,&l10.ht., _ Will )6-(kardsa-- Phone Nu rnbeP `1 iG1 .3(rq.
Dject Lod ati- (County,
Road, Water Body, etc.)
tip
ak
pe and Dimensions of P�jroject1 -ItQ40k l_ C 1-�t) LAt1S G�/' ,G�� A 6 j- „ ICJ � I1AJ L�
.A ; . +. 1.'� l i� .0 X l L,ll ��1 C A /A d1/\-P,v�� �� Yl ( V C 1 , f r f c i'(lq
proposed project to be located and constructed as described
)ve is hereby certified as exempt from the CAMA permit re-
rement pursuant to 15 NCAC 7K .0203. This exemption to
MA permit requirements does not alleviate the necessity of
jr obtaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA F
valid for 90 days from the date of issuance. Following ex
a re-examination of the project and project site may be ne
to continue this certification.
KETCH (SCALE:
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l au A 0 A,d W. G� 61 WOW Wadi wk-� n
y
J
�CKTi ISZ,
Qr1LK�k �ArD
110�/�-

ft
replace existing seawall
West
gent property pid# 231 pf008
irol Sue Readling
37 Waterview Dr. Sw
apply, NC
�t
Property Owner
P I D #231 pf007
Robert & Mary Mallaney
3129 Waterview Dr SW
Supply NC 28462
910-842-2490
Contractor/ Autorized Agent: 74feet total
Richardson Construction
Will Richardson
3235 Seacrest Ave SW
Supply NC 28462
910-367-0335
richardsonconst@atmc. net
concrete bulkhead
pier
NORTH
East
Adjacent property PID# Z
Thomas Dixon
3121 Waterview Dr
Supply NC 2846�
existing boat lift

-ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIEAIMOORLNG PILIlYGSIBOATLIFTIBOATHOUSE)
I herebv certify that I own property adjacent to R2 Q 's
(-Name of Property Owder)
property located at
(Lot, BIock, Road, etc.)
on - C,l 1 , in 6 /z
(Waterbody) own and/or County)
, /c
Applicant's phone #� of J ) Mailing Address:,-'Sl�) 7
24 LA,
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 / boailift / boathouse
must be set back a minimum distance of fifteen feet (15D from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
�r I do wish to waive that setback requirement.
DESCRIPTION A_ti-D/OR DRAWLNG OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
Mailing Address
-10"Q��,,
City/9tate/Z
J
(Riparian Property Owner Information)
_ ature
Prin r Type Name

ADJACENT RIPARI.AIN' PROPERTY OWIN STATEMENT
(FOP A PIER/MOORL'YG PH-&GSBOATLIFTIBO_.4TBOUSE)
I hereby certify that I own propertyadjacent to -R , _ A O `s
Game of Property Ower)
property located at ,-5f Q cf
(Lot, Block, Road, etc.)
on .ZC.L`1 in �6: I , N.C.
(' aterbody) ('Town andlor County)
Applicant's phoneT_-JW)TaAddress:
ilina
b
.r .1.�AJQ
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 pierlmooring pilings i boatlifr !boathouse
must be set back a minimum distance of fifteen feet (I �9 from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement_
DESCRIPTION A_ND/OR DRAWL\G OF PROPOSED DEVELOPIVIENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
?X/ 9 2-4,IC r f
Mailing Address
Cityltate"z
(Riparian Property- Owner Inform tion)
i�nature
Print or Tvpe Name

,verly Eaves Perdue
Dvernor
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
James H. Gregson Dee Frei
Director Seci
AGENT AUTHORIZATION FORM
Date: 9
me of Property Owner Applying for Permit: Name of Authorized Agent for this project:
rner's Mailing Address:
Agent's Mailing Address:
lone Number ff/ 1)) 2g-a - o Phone Number /u ) ac )'
ertify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
and obtaining all CAM IA Permits necessary to install or cconstructth`ee following (activity):
1 krs+ ij
iy property located) at
its certification is valid thru (date)/

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