Smith (15)

CERTIFICATION OF EXEMPTION
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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.0203.
icant Name A 1 \-t So n-- ,S,M,'t"L, Phone Number c*/Io I ..)'?--o
•ess j;,0 7 L J I r-O6 IL. ( t2 .
.1(d 24 S /F'(- 1c y State 41 e Zip ). g
)ct Location(County, State Road, Water Body, etc.) Sl'n ci-s Alm, ) .? AA' , (P•-f ,Je, P2 J
,,s Jo v-I C .. '
and Dimensions of Project N.ci-PPS„r o 1--- ,fi Q KI- -4k. , 412 4 9 "� -' S4. 1 r j
"?.1<. ( n-2,
>roposed project to be located and constructed as described This certification of exemption from requiring a CAMA pei
e is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expir
ment pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be nece
A permit requirements does not alleviate the necessity of to continue this certification.
obtaining any other State, Federal,or Local authorization.
ETCH (SCALE:
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j.LCENT RIFAR I�4N P O� RTY C? R Nmir nQNlWn .A,9
Name of-Individual Applying For Permit f)L d tc
Address of Pi vpe�riy__-___��Q , 1 L.\,S,r`ud
(Lot or Street#, Street or Road)Cl•-)0V26 � ftlZ
(City and County) ---
I hereby certify that r own property adjacent to the above-referenced abctve-referenced property. The individual
applying for this pit 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 pragoxal.
If you have objections to 'hat is being proposed, please write the Divfaioo of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 9I0.395-3900
within 10 days of receipt of this aotiee. No response is contider+ed the same as no objection if
you have been notified by Certified Main
W11VER ne'I`m)N
I understand that a pier,dock,mooring pilings, breakwater,boat Waft or boat lift must be
set bck a minimum stance of 15'irons mp area of riparian access-unless waived by me. (If
Yoe wish to waive the setback,yaw most initial tie approprdatt blank below.)
I do wish oa waive the 15'setback requirement.
do nab wish to waive the 15'setback requitement.
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dame
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it Name -'..-1"'.--
•
NCDENR
Number with Arica Code
camaisbellslripecianpropetty.frm

r ruvnio rwia y rv-crv-i t ry N.
ADJACENT RIPARmAN PROPJRTY OWNER NOTWICATION1WA.iVER FORM
Jame of Individual Applying For Permit: L
ddress of Property: Orl � = -
(Lot or Street 11, Street or Road)
(City and County)
ae..reby certify that I own property adjacent to the above-referenced property.
plying for this permit has described to me as shown on the attached drawing
p FAY The individualtthey
proposing. A description or drawing, with dimensions,should be provided the with t rein
this letter.
✓� 1 have no objections to this proposal,
you have objections to what is
'ua cm,eu 127 Cardinal being proposed, �� write the Division of Coastal
g Drive Extension, Wilmington, NC 28405 or call 910-395-3900
Mu 10 days of receipt of this notice. No response is considered the same as no objection if
have been notified by Certified Mail.
:�TION
derstand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
sek n minimum distance of 15'from my area of riparian access-
wish to waive the setback,you-must initial the appropriate blankbel waived by me. (If
w.)
I do wish to waive the 15'setback requirement.
_- _. I not wish to waive the 15'setback require' mmerxt.
dame
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