Brixey

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT P U 50 9 I b A
as authorized by the State of North Carolina,
0 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.
Applicant Name EKcc (' tiY., F k.,1 Phone Number 9 44-1744o3 0 U)
Address ll Co tor\'ti A l 1 Nvc..nue,/
City M-,c_(' e ,n State IU Zip c>?6315
Project Location(County, St to Road,Water Body, etc.) C' 1-ui r ?.2 at,
is iei WPrv\ � r?C-c C e'�1w' LAINd'i 11c-� S,.a 4 � �I t t�
Type and Dimensions of Project tk,\CAiJ u 1V-N. rt , 1 v,nri wfry 8 nc fn'err c j- c [-I\ S5
The proposed project to be located and constructed as described This certification of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expiration,
quirement pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be necessary
CAMA permit requirements does not alleviate the necessity of to continue this certification.
your obtaining any other State, Federal,or Local authorization.
SKETCH (SCALE: >�o-t- to )
(pi e-e- ,. 90%)(V c e...,ksk,,- )
pt T t.„) ."
�• 8161 �DS1 ! r �U Ste' d I
i I ce_tA) 6AA\---‘-- CA 1
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in., •
Any person who proceeds with a development without the con- e
44/1"-------___.
sent of a CAMA official under the mistaken assumption that the 2.,,?1_,V,
anYs sii a re
development is exempted,will be in violation of the CAMA if therea.
is a subsequent determination that a permit was required for the / � '-
development. CAMA Official's signature
The applicant certifies by signing this exemption that (1)the ap- / ` ek �t UO
Issuing dat 4A-2r
plicant has read and will abide by the conditions of this exemp-
tion,and(2)a written statement has been obtained from adjacent u q1' 1 i 00
landowners certifying that they have no objections to the Expiration date U
proposed work.
Attachment: 15 North Carolina Administrative Code 7K.0203

ju'Ji
05/07/02 TUE 07:33 FAX [phone] EbTES Al:SEM/ AN•
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTI 'ICATIONJwAIVER. PORK
. Name Of Individual Applying For Permit: � ��� t ys VI- 7
Address-Of Property: c,a. ((' C fl it/ � �
t 1 \A. 2�4�z J
(Lot *or pt.reet #, Street or Road, City & County)
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.
f you have objections to what is beincL vronosed. blease write the
Division of Coastal, Management. - 7 cardinal D ive Extension•
Wilminoton, North Carolina. 28405 or call 910 395-390o within 10
days of receipt of this notice_ Na resmonse is considered the same
as no objection if you have been notified by Certified Mail
WAIVER SECTION •
I understand that a pier, deck, mooring pilings, breakwater, boat
house, lift 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 requirerent.
I do not wish to waive the 15'setbaCk requirement.
•
•
. Aaf F-6 A21rA,
Signature /1 Date •
Print Name ���
dEHNF
Telephone Number With Area Code
Ii
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1

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER-. FORM
. Name Of Individual Applying For Permit: L/ P�,Lp r"
, %
Address"Of Property: d geo _ 6-co
(Lot *or Street #, Street or Road, City & County)
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.
•
C./ I have no objections to this proposal.
p
.
If you have objections to what is being proposed. please write the
Division of Coastal Management, 127 Cardinal Drive- Extension,
Wilmina-ton , North Carolina, 28405 or call 910 395-3900 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 _ 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.
•
14.
S g ature D 6 Ar A
Print Name ���nak
3-6 11 (IL " ED. FAN 1=1
Telephone Number With Area Code