Ward (4)

- CERTIFICATION OF EXEMPTION
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FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, U ` ��
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 -1To (1A 1d Li, Phone Number (.t4(''- 336O
Address 2c5'- Tcr\rs irl 1.Ja-f ry Cr., tl C.--
City , State IJV ) Zip 0164 72_
Project Location (County, State Road,Water Body, etc.) -S r uc.ns tA)f C 1— Ciu w..4a_ 3(, Z3
\.J L tfi , 41..c P ,1 ( 1 J i r.A t.•Ii o t(\ ) 1\T w t.)
Type and Dimensions of Project 1 t P - C P� ran 5‘..Ntir e• 1', IN r J .le-NoU C ;fir;-rn k%'11n 1.01:1 �-(.
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- / /.� '-r I
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 (\r-\ ._
is a subsequent determination that a permit was required for the
development. CA Oltjcial's signature
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The applicant certifies by signing this exemption that(1)the ap- 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 r -)0 ,.•WZ
landowners certifying that they have no objections to the Expiration date
proposed work.
Attachment: 15 North Carolina Administrative Code 7K.0203

Applicant's Name Dail/ R. 6✓a�-�(
Address of Property 36 2.3 R1'Per!/','e tv /V S/4/ Sc.rri1y '
Applicant's telephone number 970 6 516 -3366.
I hereby certify that I own property adjacent to the above reference property. The applicant has
provided me a drawing of his intent to establish rip rap at the foot of the slope near the high
water mark on his property. I understand the location of the rip rap will be determined by The
Division of Coastal Management.
have no objections to this proposal
ItLiksYSIST
Signature Date
V4151230 L. SAA�"�v1 .43 21 iii/E,L 1/;47--uo L N (A)
Print Name and Mailing Address S NV�, 281/L -
P �' 7
(Iii3) 842 -2 315-
Telephone Number with area code
If you have objections to the applicant's proposal,you should contact the Local CAMA Permit
Officer listed below as soon as possible to register your concerns:
Janet Russell
Division of Coastal Management
127 Cardinal Drive Ext. Wilmington
Telephone: [phone]

-
10/30/01 TUE 08 32 FAX [phone] ASM MAIL ROOM �003
OCT,-3J -01 07 26 TEL:5464E70 p:
a r
xy ,.
' A Can Name 4�� 1Q. '1� r y�
{ •
f Address of Property 3ln GI /]I�6�t't 11�'�r�/ LA/ $" 1,1/
' .Applictint's telephone, number 9/0, ,co i _ 33,�
I hereby certify that I own property adjacent to the above reference property. The applicant has
provided me a drawing of his intent to-establish rip rap at the foot of the slope near the high
water mark on his property, 1 understand the location of the rip rap will be determined by The
Division of Coastal Management
• l have no objections to this proposal
• ._ - , - .
/073c)/0(
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Signature , Date
f},:n L 7(110 7
• Print Name and Mailing Ad.druss
:::Telephone Number with area code •
If you have objections to the applicant's proposal,you should contact the Local CAMA Permit
Officer listed below as soon as possible to register your concerns:
,. - • Janet Russell
•:• . -- Division of Coastal Manabenietil
= 127 Csirdinal Drive F.xt. Wilmington
Telephone: [phone]
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