HomeMy WebLinkAboutGillie • CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT P 080814 -�
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 Phone Number 8 cof
Address 22, Co SA 1'� wl!nCi Lk) State 5�J Zip
City rr.,1- • 1e_c Prn#
Project Location(County,State Road,Water Body, etc.) c tx r\s►� r �... r�t.\.r',f1 , 131 S�t �� S k
t\u1de_ .N "la,emch N� , Nam.- 1N1nrIF y V\
Type and Dimensions of Project X••d clot k- t ik.7141\'� t^4- 40(
CL&JPrrd c:�, of jt)t� s h� 11 not be �A rf1—-rr' n►k+ �•,� -t"h( ,
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: i OT —r
' 1ft'4.N- nfl(3k
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�'1oA�c N o more
1 2-
111 boAt% c, �•�s
to' 410' R} ,r\cl 40ck
`; a-0
18 Nero*
5v' k - kc cka Lor
-- C'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 -
development. CAMA Official's ignature
Wa 6 a.°01
The applicant certifies by signing this exemption that (1)the ap Issuing date (j '
plicant has read and will abide by the conditions of this exemp-
tion,and(2)a written statement has been obtained from adjacent c 1cn1.p,Y,,�,(,s-,, 8 aQd
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 MANAGEMLVT
ADJAC?NT RTP RIAN PROPERTY OWNER NOTIr ICATION/WAIV-zZ.. FORM
�.
. Name Of Individual Applying For Permit: Sco f C_ G I/ r e_
Address-Of Property: 33
ar
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d ( a.C_ 1JC R "I (2 a .
(Lot or Street #, Street or Road
City & Cc_.._
�v)
i hereby certify that I own property , adjacent
to the above-
referenced property. The individual applying for this permit hasdescribed to me as shown on the attached drawing
they are proposing• A description the developmentim
should be provided with this letter, or drawing, with dimensions,
_ I have no objections to this proposal.
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If VOII have ObleCt?OP.s .
to what is bei oo
Division of Coastal M ra. a nC pro sea. ple=sc write the
i l ana �m nt . 12% Cardinal
�' _Ti1nC�.03't North Carolina . 28405i.. _ Drive Extension .
0
dais of =; o c= this notice. or call 910 385-3500 within o1
as n0 Obi or-tlOn � = VGu have been No I'"''c5vCn5c'� is considered thesame
noti ~ ed lbv Corti f i .=�. Mail
7AIV='R SECTION .
I understand thatpier,
house,n st a must dock, mooring pilings, breakwater, t
be set back a minimum distanceboat
from my area of riparian access unless waived (Iyou_wish'
to waive the setback, by
you must initialme. (_T eblank
below. ) the appropriate tan
I do wish to waive the 15 'setback re=uirement.
I do not wish to waive the 5 'czt,^aC}C requirement.
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Date ArrArA
rint Name �
/0.. G G - v a,. ^----- 41111
Telephone Number W1,h Area Code H
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