Myers (3)

. - 1/
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT p Oy 05 I 6
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.
Applicant Name We Sit 1 \ e4- Phone Number Ali, 1u ' t., I- amtl
Address
City C . tr = `,', 1\ P State d Zip , 1 t13a
Project Location (County, State load, Water Body, etc`.) c tA n S t+I,c r U Van 12 c1 -hy -\ 1
Type and Dimensions of Project NC,\A) p,._r end F (,)(\4 ,n rt Gi p r
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: J UTr ;r )
M f\-- 1 - n fld� Cj 1
< a°�
'p, c-1vAT
t.r 1.- y es x p t mot' y ,y
�' �� -
I" V '
I
I 50' vPe -r 1
1 wT
i
, / i f c___
Any person who proceeds with a development without the con- Ct /�t!(4/14
sent of a CAMA official under the mistaken assumption that the Applicant's signatur /I
development is exempted,will be in violation of the CAMA if there nn
is a subsequent determination that a permit was required for the ,,, M - . .
� CAMM(.3fficial's signature
development. /
The applicant certifies by signing this exemption that (1)the ap- ) oZ UU
Issuing date
plicant has read and will abide by the conditions of this exemp-
tion,and(2)a written statement has been obtained from adjacent ---! ,5 I c)UU i
landowners certifying that they have no objections to the Expiration date
proposed work.
Attachment: 15 North Carolina Administrative Code 7K.0203

•,,,,y,f"-..
D 16:51 FAX [phone] CanFasZ 002
rlly'[SION'-_i)F_.C(2ASTALM ANAi.iEMFNT
ADJA.CEN:11.RIPA IANTROYERTYA).rl�➢E�B . OTIFIC A'CitlN/W.4INTR FORM
Name vt Individual Applying For Permit: ) ' till ..)
Address Of Property: _j ) fiL +..� /YLi b4,,
�
H-c,ki-)LiLiq_ 13a. dc liVc_ avt,tiptatUd(--
(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 'rrie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
.,.--
Li___ I have no objectiolLs to this proposal.
1- -- 'e__.ub_eLt' ioJl._s7 what _taming .props ,--.pl- -w'tlie_ the_T)vision-of Coastal
ManageMent,_127 Nprtkf`ardirtaLntiverWtlmingtsm, N_�n th ('ate ina ..2# )S or.cal!_910_395
'. �cithit i U ,-ys_o res,6' t nt nuh sju ice Nia_respoue is_considered the same AS no
lou have btenr _hyj-
ruffled. j�.CIiQI2
�y_
WAIVER sECfl01y
1 understand that e 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 beIow.)
.�; c-' _- _ _ I do wish to waive the 15' setback requirement.
(, . ,.. 1 Ort not wish to waive the 15' setback requirement,
ter--W_ - - .. '
A . .isi,
Sigpature /� Dat� -
.0.ftra..woogaimprill r
PrG.i-fit Name __ ---.--_ . _ _4. .___
/i c-j — ,,S i c:,) — 0 - 71 7 ..,-; NCDENR
___ _ ..... _..... .._ ..
Telephone Number With Area Code NORTH C..AROG..I�IA DE,PAR7MK;NT OF
EMVIRONMENr.W+y NArU.... RL50LIRers

iNosajatlea0 6M.9,4 c1/2,
Venir :71s,
,.,..._.�, M wtL�+
�ii' ' /i�T 7
r`' 7 - r
•
�.ww... _
' 61,mg ltbsT xDvga*silt •Ltu sAT*A Gad, RIS A Iron 0, t
=zuaai*xTnIma 4au es,51 egg *Atli A 01 taR A a
) mom elegadoaddr stn Te/aTu/ a no1� ' t M8 E a
t4eTs no i3) '•m .� Z �ioe es * Y•�
a psAita sss vri ssraa• u•Ts*dla as •.ice .its Qoa=
,St ;o *r.,4*4$Tp arASTUS, ! sc( ast PC1 wins sbrtgpu•s 30 s,xTT '�►.er,ott 4toq '. s' lriX*Igaq 'sioujj;d bulaoo i ,Noo 9 •lls a %Intl p it:s:2spun I
r r ; j
'da3saoaxa - , r .
T:ticc►dosd s;uz ca. suo7z0spsto ems+► stmet Y
.,;wwz,st 1E742 41114 p+ptiooad 1q pTnoVs
•uo susui' p ij pp- Lbul elp u07 dTaasep -bug sodoad aalt A*
auipadOtworp eq4 bM piup p•gaima0 ova uo UAOtts ss lop n4 per/TaOersp
• ;Itar►d inm; ;o; buTAtdd• I•hpTATpuT •u `A4=*deed +gOuloaw,z+sa
-.ACM, *4 l tr pe R4a*d0sd ur►a / 2.11W4- a 'ca,ssc 1tq• 0v
t q rrto Aix ' fa av z•sa 44.aza
a2,..3°Z)
:d •dclad ;pro asp agar"
='T od A• " bu3Atddtt T;np' ATpu/ ;a slaws
•
i u k J iut, �L 9NC-3hrE lTE U:P@ TtA7!P?/ci
��31�E1 3�� d 6i==TTT39@+ t' RV:TT T��t=1� ; �. �r'�' _

A ,;7
A ,
i
\
i I
lb nO F O.
v
,.. 914 410
r
re-I it.,
•
,.._
•
/ 1 ta1 r
il phill

LZ1 1 - idpoQ toZI ‘ 2 I
t .