Estridge

CERTIFICATION OF EXEMPTION
-Y
FROM REQUIRING A CAMA PERMIT '1 0.6 01 I e t
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 v • \(\A r'I c C....., Phone Number 704 4114—9 r31 /
Address 1'l 1UO Rtri r'1 R U '� �c-{r +11 TZot\d
City 110r uJOorj ` State . NC, ZipcQ 126
Project Location(County,State Road. ,Water
Body, etc. f l.t n Sw k C -- ( ,tA-..t'd 13 cf T
(,p,a v- LAr, r\'tn� 1( t.)AA , � ui ‘ 1A } R = Jt..J 1
Type and Dimensions of Project s3 .4 b N IK-1.a.-- d ion' i U(\c� A A (1 t U-A r d
LIt i' \t1 i •ter. �:�( 6 �S J
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.
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Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assumption that the Applicant's signature
development is exempted,will be in violation of the CAMA if there /
is a subsequent determination that a permit was required for the 7
development. _ CAMA Official's signature
i -vt- 1 t ao6 z
The applicant certifies by signing this exemption that (1)the ap- 1
Issuing date
plicant has read and will abide by the conditions of this exemp- 4
tion,and(2)a written statement has been obtained from adjacent )'��t�C)tak 9- f 0 U _
landowners certifying that they have no objections to the Expiration date
proposed work.
Attachment: 15 North Carolina Administrative Code 7K.0203

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER. FORM
. Name Of Individual Applying For Permit: c T v w
. - -e_ .
Address'Of Property: O/.5- ��� e s�0,AS
zs_
o''�p i .c_ ? 7(0( 2
(Lot 'or Sttree #, 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 pro - ded with this letter.
I have no objections to this proposal.
•
•
If you have ob-ections to what is beinct proposed. please write the
Division of Coastal Management, 127 Cardinal Dri-ve.Y:Extension,
Wilmington. North Carolina. 28405 or call 910 395-3900 within 10
days of receipt of this notice. No response is considered the same
as no obiection 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.
•
C�„�.� %I cam- —/Y---� .
• rwrYF
tune Date ` •
Print Name
Nr
Telephone rN�berJ If f A 3 cog 1 e)—Tiga 711k3 n ��Ft

•
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER- FORM
. Name Of Individual Applying For Permit: a rnatik
of
Address'Of Property: 1 3 g 5 'C 2� J
(Lot or StVae 4, street or Road, City & County)
Y
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 objections to what is being proposed, please write the
Division of . Coastal Manaaement, 127 Cardinal Drive Extension,
Wilmington , North Carolina, 28405 or call 910 395-3900 within 10
days of receipt of this notice. No response is considered the same
as no ob-iection 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.
•
LOZ(214e,',;‘, J62,1,‘,,,,Z11
Signature c DateA •
L01 /114 4 rAo,v, I ( 'u ! 1.<
Print Name
Telephone Number With Area Co e