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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
r in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
7.
Applicant Name MP L6 ip, - l.A3 E-t45 10 S niar( Phone umber '25 4j2
Address 3I .., rAaye-yes.K
City A J G�#T S VState t•J Cr \ Zip 2_Ft¢gQ
Project Location
Location(County,State�Road,
�Water Body,etc.) --r Q1 r�.t v—� Pi �C 1'C—
CAt.1A L KlTc 1r OT c 11 n !� 1 / _`mil "�"' ,0 ,
Type and Dimensions of Project C5010—TYTc..GT ( (L
S lc) -Ca_ sus oy-, - -r- 7t^I o E-t11 usi..9e
1.- -Ea R. CikrAA ON4 Ni.:) ri- -1s. i4;) L - 1 A i Nci
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- L C1'6�7V�
sent of a CAMA official under the mistaken assumption that the Applicant' ' atu
development is exempted,will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development. \'1'J--
CAMA Official's signature
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 1 t 1 0 y�y1
landowners certifying that they have no objections to the Expiration date
proposed work.
Attachment: 15 North Carolina Administrative Code 7K.0203
t •
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
Name of individual applying for permit i 1L Uwk 111a4,q
���
Address of property Da. 60100,14147Cott. '
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 of notification.
Please initial below if you have no objections.
I have no objections to this proposal.
r,67114
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, N. C. 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,Iift or
sandbags must be set back a minimum 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.
4(:)/V.
Signature & Date
r 0 lc/ f 'c NI 7 Print Name
9 j 0 _ 2 r5 Telephone Number w/Area Code
PLEASE SIGN AND RETURN TO; F&S Marine Contractors,lnc.
P.O. Box 868
Wrightsville Beach, N.C. 28480
Phone/Fax (910) 256-3062
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION & WAIVER FORM
Name of individual applying for permit kilA ' 14%)45
Address of propertyJ) ( 14( 1, UX 77 6�✓' ' 04441 M.,J J
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 of notification.
Please initial below if you have no objections. `d 1; yk
I have no objections to this proposal. fir6i6149jaI '*z q-
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, N. C. 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 or
sandbags must be set back a minimum 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.
(?(Ytit Signature & Date < / t/
(1,p, u S7 '7 Print Name
(9/c) ?�J a-! 6/ Telephone Number w/ Area Code
PLEASE SIGN AND RETURN TO; F&S Marine Contractors,lnc.
P.O. Box 868
Wrightsville Beach, N.C. 28480
Phone/Fax (910) 256-3062
F&8 Marine contractors, Inc.
Complete Marine Construction Service i
•/Pak'
D k� ��^ r For Over 25 Years
CAPT. ED FLYNN ' `' DURWOOD SYKES
411111 ,,
^/ Piers, Floating Docks,Pilings,Bulkheads,
IAib71t}� tr , W C_ Repairs, House Pilings,&Boat Lifts
1 P.O. Box 868 Phone/Fax: (910) 256-306'
Wrightsville Beach, N.C. 28480 email: efly@msn.corr
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