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CERTIFICATION OF EXEMPTION
_�/ FROM REQUIRING A CAMA PERMIT (�ts �/' 0574 /c
\� as authorized by the State of North Carolina,
t'' Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area/of environmental concern pursuant to 15 NCAC Subchapter 7K.0203.
'icant Name ie4L. , / .pp7 Phone Number '�
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I,/' i$?/;0 */:; '� tate - �Zic" • Zip
ect Location(G'�jnty, State RoaadJpater Body, etc.) /i / w/l �3(e<.i .y
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e and P�im nsions of Project jl,A1/Gcp PA-Yli ' '.-c/a ' / --/ 7-- 4r
proposed project to be located and constructed as described This certification of exemption from requiring a CAMA pe
re is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expi
ment pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be necE
IA permit requirements does not alleviate the necessity of to continue this certification.
obtaining any other State, Federal,or Local authorization.
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y'" North Carolina Department
"e _ of Environment and
NCDENR Natural Resources
Overbeck/Pippin Marine Contractors, LLC
P.O. Box 716
Wrightsville Beach, NC 28480
Adjacent Property Owner Notification/Waiver Form
Name of Individual Applying for Permit:q ckt\ fAvv1?
Address of Property: (,Q 4 5(1)L
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objection to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call [phone] within
10 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
Waiver Section
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15'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 wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement
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Gorrell Porperty I I
John M. Jr& Rachel C. Camp REBUILD EXISTING Overbeck/ Pippin Marine, LLC
64 Beach Road South Wrightsville Beach, NC
Figure Eight Island TEE HEAD 910.256.3082

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete wjg4r:'\
item 4 if Restricted Delivery is desired. ❑Agent
• Print your name and address on the reverse ❑Addressee
so that we can return the card to you. /g. eceived by(Prf ed Name) C. Date of Delivery
• Attach this card to the back of the mailpiece, I 1
or on the front if space permits. �� 6 Q�� l✓ /`�` '�
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: nn nn If YES,enter delivery address below: No��v\ Cy -D`Q.\\ , J�
GCS 03v,e ;co\a�
C_n e„.,�3' ,_n O ( 3. Service-type
\��'� , \�1 / Ip ertified Mail 0 Express Mail
❑Registered 0 Retum Receipt for Merchandise
:')4A 0 0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number
(Transfer from service labeq 7005 0390 0005 3653 2055
PS Form 3811, February 2004 Domestic Retum Receipt 102595-02-M-1540
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. tom►'
item 4 if Restricted Delivery is desired. , 0 Agent
40• Print your name and address on the reverse OcAddressee
so that we can return the card to you. B. Received by Printed N ) C Date >f iv�
• Attach this card to the back of the mailpiece, ^�' � `�, ) /
or on the front if space permits. ` HN/ 1 C/ ` ��
D. Is delivery address different from item 1? ►--I Yes
1. Article Addressed to: If YES,enter delivery address below: 14o
(at\\rLA iC\Y-AAd\
\(00 ce-e54
011� Mail 0 Express Mail
a7Z ❑ Registered 0 Return Receipt for Merchandise
❑ Insured Mail 0 C.O.D.
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