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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
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name 0_06e rt t-A't,LI.R4 (iG .-C. ,U Vt ib c.k Phone Number 10)2 -3O?
Address 23 12 Or-e—1 t 4 jI)p- . LA NJ b F141
City J i L,yr.i yka qq ty-.n State f.J Zip s
Project Location(County,SL to Road Water Body, etc.) S A�_1v-Q , Pt -Ca.,
D � / ",f( y
Type and Dimensions of Project try r Pe S ({J t•-).c fr M{ 'A.).` - LA1 (15 e
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
sent of a CAMA official under the mistaken assumption that the Applicari's ' re .ce:_NN)....N;I____,.
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 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 \ ` ,P-6 v

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DIVISIQN OE. COASTAL MANAG tMENI
ADJACENT RIPARIAN PRQPER X OWNER �1OTIPt CAT IQN/WAINTER_ FOR`(
Name Of Individual Applying For Permit: 20SERil Z).
Address Of Property: 242.Z Dc1 Y-r ?'
(Lot or Street f, Street or Road, City .& Cou t`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 developrent
they are proposing. A description or drawing, with dimensions,
s ld be/ provided with this letter.
V _ I have no objections to this proposal.
•
u eve ob 'e ions to what is being o goosed . please write the
v' ofCoastal Management.
Tnin_cto»•_ North Catalina 28da5 Cai d1al Drive yF Q±,,_, I,
Q cal1 9I0 395 3900 t ithi 10
devs Qf recejot of thy, notice. No re,uo_nse ]_s cgr�sidered the 7eme
s O b .e^ti i OU av en fie by Cer d M
emminis
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wAIV R SECTION
I understand that a pier, dock, mooring pilings, breakwater, beat
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.)
IlA t/ I do Wish to waive the 15'setback -f
� ck requirement.
_ I dP not wish to waive the 15'setback requirement.
•
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Pri t N me _ _
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Tel phe a Number With Ares Code
CMItedi IMl�rine Cam+
LLC
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Wfistartilk Beieti.NC 21480

DIVISION OF COASTAL MANAG IENT
ADJACENT RIPARXM P1OPZRTY O IPTIF/CAT iow/wArvp..yoi
Name Of Individual Applying For Permit: C-43EZi:
Address Of Property: i3(7..
(Lot or Street , Street or Roar , 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 provided with this letter.
I have no objections to this proposal.
If"cu ave & ans to wat $_.bear tronosed,
D..ivieion of Cot€. taLj'ianaaem . ina1 Drive Extsngjots.
a Ana 2840or_call,_,9i 345 390jiithin In
s3av .o '_.Xeceiat of t its notjce. N idered the seta
er V11.jaw ja2ratassi_p_tsattivaLmail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, best
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 sag not wish to waive the 15'setback requirement.
•
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s tu _r Date ATA
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Print Namemasiemmilm `
Or-- c \D-\0. --`z-\Z-� E I N FR
Telephone Number Wina Area Code
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