Holmberg

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 environmentaltl concern pursuant to 15 NCAC Subchapter 7K .0203.
� `T Applicant Name � t r r� in C.Quer Phone Numbe(IC) 2 r 4 i -
Address �'� x�3� te Cr r- T ,0?Ww2.
City LAji IW vP. State t.-C k_ Zip ZS47c
Project Location(Cour�S State Road Water Body, etc.) e-
o ►,o . PAD Ca..--
4_ m- r
Type and Dimensions of Pr ject t S l ij t.Q mc-4 C&.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- �-
sent of a CAMA official under the mistaken assumption that the Applicant's sig...tur
development is exempted,will be in violation of the CAMA if there 7
is a subsequent determination that a permit was required for the
development. CAMA Official's i nature `�
f' bysigningthis exemption that (1)the a - ��2
The applicant certifies P P 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 0 Z

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DIVISION OF COASTAL MANACZMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER- FORM
Name Of Individual Applying For Permit: C � ,h^' , , ,de;7
Address Of Property: f/j, ,2 z g7 n74✓'IYv`
.!
/ 'J i/i 3/70 ve '� ( f,1)-17'
(Lot or Str et �eet 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 me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, •
should be provided with this letter.
)C I have no objections to this proposal.
If you have objections to what is beina Proposed . please write the
Division of Coastal Manaaement, 127 cardinal Drive Extension,
Wilminaton , North Carolina, 28405 or call 910 395-3900 within 10
days of receipt of this r_otice. No response is considered the same
as no oblecton if you have been notified by Certified Mail
WAIVER 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 ;lust initial the appropriate blank
below. )
kA I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
;/4
„.
si 9&_ a Date
ATICV(
•
1 L � , P. r
Print Name
1/0 sad-/303 ED 1--IfN1R
Telephone Number With Area Code
Meise +aC
Ord/ NI 110 716

ent By; Sands Capital Management; 202 528 4001 ; Jul-21 -00 10:57AM; Page 1 /1
Heceluac: 7/21 /00 10:33AM; 910 692 e550 -r Sense Capital Managamsnt; Fag* 3
07/21/00 FRI 10:16 FAX [phone] Centre W. Holmberg (Z003
DIVISION OF COASTAL MANACJMEN'1
ADJACENT RIPAWIAN PROPERTY OWNER NOTTFICATIONIWAIVFp_ TORN
Name Of Individual Applying For Permit: r-,QA7/,'' �l �fl de/` /
Address Of Property: .4074//, ,,2 42a a'P_&,7 /l11.)2f•fi
r"/Pe
mr� it/ib'?10 v�er- ( um5
(Lot or street ,� treet 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 me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions,
should be provided with this letter.
)C I have no objections to this proposal.
•
•
If you have objections tp what is being bromosed, _please write the
Division of Coastal Manaaement. 127 Cardinal _Drive Extensions
,iq.. lminaton , Nortil Carolina , 28405 or call 910 395-3900 within 10
days of receipt of this notice. No response is considered the
as no objection ifsame
u have -been notified by CQrtiffgd Mail
WAIVER 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 gust initial the appropr1ate blank
below. )
Nam_ I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement.
e_o__/// . )r) -;r4;-/ UG •
Signatus
Date
P nt Name/2/S`til/� 717 -flTA/DT Ara
e 7-y/ fi3.I f 6) lC,)S -Fr- )c-)v 4 H R
T 1 none Number With Area Code
Ore' Hipp P. .1 x716 •
• %Woo&ia.ela.NC MN
MO)236.1082