Thorton

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 .0203.
icant Name ) Phone Number 1/Q-317-Lb)
-ess .a H
State N,C_ Zip
act Location (County, State Road, Water Body, etc.)
and Dimensions of Project y �- �2 1".i+1 AEI , j3 ' �" -0 ►�i
) - 0A2,1 to/try ?yi'� 1�1
proposed project to be located and constructed as described This certification of exemption from requiring a CAMA pe
e 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 nec(
A permit requirements does not alleviate the necessity of to continue this certification.
obtaining any other State, Federal,or Local authorization.
ETCH (SCALE:
! l

DIVISION OF COASTAL MANA(.4 vf.NT
ADJACENT RIPARIAN PROPERTY OWNER N(1T11^I( A TII. ?N1W/11 V_ER.F()RM
of Individual Apply ng l-or Permit: Wes >0 1orTu"
:ss of Property: off.1 Q 7)
(Lot (-1r Street 4, Street or Road)
(City and County)
:by certify that I. own property adjacent to the above-reff •enced property. The individual
Ping for this permit has described to me as shown on the att .c ied drawing the development they
roposing. A description or drawing, With dimensions; shy id be provided with this letter.
I have no objections to this proposa .
wn have objections to what is being proposed, pleas( write the Division of Coastal
agement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
in 10 days of receipt of this notice. No response is consi. cred the same as no objection if
have been notified by Certified Mail.
•
WAIVER SECTION
Jerstand that a pier,dock,mooring pilings,breakwater, .oat house or boat lift must be set
a minimum distance of 15' from my area of riparian ace ss -unless waived by me. (If you
to waive the setback, you must Initial the appropriate 'lank below.)
I do wish to waive the 15' setback requires lent.
.
1 do r191 wish to waive the 15' setback req irement.
iNa . e ate A73.79PA�.

:)IVIS1C)N OF COASTAL MANAG-._ !IN 1-
CF'l1I RdPARUAN PROPERTY t)WNIr'TZ T EIC 47 1ON AIV1:71: FORM
ne of'Individual Applying For Permit:( r1 --¶Mh'b4C01_ Yli%t .o
tress of Property: Rio "ae
(Lot or Street #, Street or Road)
e0��_ --y- A(,C. , bC-�(City and County)
ereby certify that 1 o•.:•n propexiy adjacent to the above-zefe enced property. The individual
;lying for this permit has described to me as shown on the attar ed drawing the development they
proposing. A description or drawing,with dimensions, shed d be provided with this letter.
U, I have no objections to this proposa
you have,objections to what is being proposed, please write the Division of Coastal
anagement, 127 Cardinal Drive Extension, Wilmington, JC 28405 or call 910-395-3900
thin 10 days of receipt of this notice. No response is covsic ered the same as no objection if
u have been notified by Certified Mail.
,_ -- _ -
WAIVER SECTION
•
inderstand that a pier,dock,mooring pilings,breakwater.1 oat house or boat lift must be set
:k a minimum distance of 15' from my area of riparian acce :s-unless waived by me. (If you
ish to waive the setback, you must initial the appropriate lank below.)
/iigak. • I do wish to waive the 15' setback requires tent. •
I do not wi h to waive the 15' setback remrenzont -. -
4 „, . _.; ._..) •/d.io s- -.ur,r-orA

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