02125D - Wilson

cant Name
CERTIFICATE OF EXEMPTION /
FROM REQUIRING A LAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K , -3
& W b 1lsor'�' U I f) ,i�lMkVi[aw ��a�i ►tie Phone Number U-323.?,-
n (County, State Road Water Body, etc.)
and Dimensions of Project
proposed project to be located and constructed as described
'e is hereby certified as exempt from the CAMA permit
irement pursuant to 15 NCAC 7K . This exemption
AMA permit requirements does not alleviate the necessity of
obtaining other State, Federal or Local authorization.
State -
4 A4-t-- 11, 11 2
This certification of exemption from requiring a CAMA
valid for 90 days from the date of issuance. Following e;
a re-examination of the project and project site may be i
to continue this certification.
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Type and Plrnene
ISS91SOOT6 03HSI-4NIJ3I63WH
CERTIFICATE OF EXEMPTION
FROM REQUIRING A C,AMA PERMIT
N° 02:
u altiltortioed by the state of North Cafollno,
9tpattantant of Emimment NO Nodtral tte MMU and the Cospal Rmu Camnkyoe
In an area of wr*mtmmul concern pum ant to 13 NCAC Subdixter 7K.
Stalo
Phone Ntmtber WmA
The popotad place to be bated and a m vcmd at datettbed Tali cerditae>1an or aeampdw from tagtd" a CAMA p
above k hereby carT1 Nas etttmpt
UMr1 peKrllt reed f jgo e,K,r..., the ate of fwunca. Following pip
rWulratrtencpur+antto 19 Gt: yK • T}tk tunettptlon a ne.eaamhWbn of the p *,a and WVW site aney be nt
to LAMA patted[ raqulremena doff not allevlste the necmdly of 4 continue this c nocatim
your obtabftnp other Slue, Fedmul or Loew aK a tatim.
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Any porbon who pmooado w fth a davolppmsnt without the ton•
sent of a LAMA olkW under tho micloken aaturmp non that the
dovelopm cm fa oa4M00d. will bo in vlokdbn of the GAMA it thole
la a eubaocuont dotorminatbn that a pormlt woe roquleod for lho
dsvolopmant.
TMo applkmrt osngipa by signing this oaomplbn ihm (f } the W
pltoam has read and will "a by tho oonditlone of ibis uxomp-
lion, a
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-16 001L11. 13,_?G f- ERICAWISHCO 9104576551
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ate` Y No* CBroba Departmnt of Envkwff eM and Natural kesnurces
Division of Coastal Management
lhicha6ti F Cask t. Cave Nfl1
r4W iti1M5 }i. Gregson, William G. Rosa Jt.. 5CwElap
Authorized Agent Consent Agreement
is hereby authorized to act an my behaN
i name ad,lpenn
in order to obtain any LAMA permit(s) required for the property listed below. Tito authorizationis limited to the
specific activities described in the attached sketch,
LOCATION OF PROJECT:
PROPERV OWNER MAILING ADDRESS:
l
PHONE NO -jq!: 0 _ 9417 - M
AUTHORIZED AGENT MAILING ADDRESS:
-aicinat a of Property Owner
5iynatUre of ALlLhOdZed

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M431,12141MILM—CLO—�_1 VW1
DIVISION OF COASTAL MANAGEMENT
AMIACENT RIPARIAN pRoprz RiY nFICA7K*MAIVER FORM
(YWNER NO
4"wh of
(i-cot (v meet 0, Street or Road,
Agent's Name
j jjwpoy ceeiry that I own proWy adjQWt to tt* above MWMW PFOPO'ty' The kx0votmo
appf�Ogljfbr 94,; pfjrl,4k ha$ desMbed to me 98 shown On ths attached ad*d 1, the devtsio ant
awy me
no *adons to olis propxwI have objectiom to fts pro"td
jyy4utwv6*4*c*ww so
(Lxmq in mmig mNAv 10 dap 01 j mc&V of 0* nObm 00"Oul k&%mmw" ftr DCU 6me" Is
evaRaMe at www necoastaimeaqgffBgnl,neljeALniact dcmm or by ed" 14884RCOAST No
mlepm!jsRteag to rise ag w Lm �fmabods - 1 0F gCWIJUW IML
WAWR SECTON, or gmn must be set.
t"Imatwo MA a pw, do* moomv pilings, b($*Wldw
bw* a 1WWmum "of IS from my area of dpmm socas wroarja waned by Mo. (K YOL
*191 to waive tilt Uft-ack you mm m appmpf we t4&* lymms
I do wish to w" the IV wfta reqWrement, .
I do M wish to waive the W aedWa MQI*~-
(pm W-ty own" wwm*�r)
V
Signamyr.
15
Pft or rype Nam
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18-2012 08:57 ANERICRI FISW.:C 3104576
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QMSICfTV OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTWICATION/WAfitER FORM
tdatrte of Prayperty Owner:
Addmas of Property:
{Lot or Steel #, Street or ROW, City & County)
�:'1 ♦ �! r �rE Address: o
Agent's lame Ao #: m
Agent's phone ! 6r4' . k-f q3 " 7py r _y i�r✓� ( , K `�
f hemby certify that € own properly adJWw* to the &bare mbranced pry/ T �e indanduat
60
apptyirig for this permit ha►$ +dastatibed to rr>e. as fihda►r► the attmtl�ed ,
+ th .tt d
tl* we ptop""'
)W ✓ _ t 1*ve no oiojechaas to this ptopasal, a- - 1 bane obfo��sarns w tlhrs
tfycwh@WCqW4DM00wiMISbefrrl► ypt„ �,biDy�„eo .krr,orCor dAfarrlMei ►
(DM in ►ar kV w*Wn 16 dip of ne00 ar Oft MOM CnrltM "UMNO n Ira DW clom is
ava8adre at www nccoasta/manaite[n l- 14 tico+�taci dcm.hrm or 6y -1 l�^dACOA.4i. NOasu
WAll" SECTION
i u Wwvtand that a pier, dock, morning pffxW, breWwS'. bogdjot"S N, or grain must be set
bK k ra trlir nw m distarm of 1 S front my area of tiP ► a unkm wsiv6d by tne. (f y%l
wish to waive the saibek, you fAWK 049 the bli * best=-)
f do wish to wvre the 16" setback neqWecrreM.
I do nett wish to waive the 19 S*b**
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ture
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