Banks (3)

t..
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT \7.
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.
46. T- R tc meli21NE
Applicant Name iSA Ni(S CH Pt N)Oft. CoN d D rn t N► u nn , j,NC Phone Number ) S09.3ff ��
Address (c) 4 'MAW.) iCl� i, LvD .
City ,:\I 4-16 F-I Tc\i U -E. S CA C h State N C Zip 2.84 f
Project Location(County,State Road, Water Body,etc.) 5\r A P,cti-e. , Pf k(e.N.) P)A I K-S
c H A N t\v t__ NJ t i-kA I, _tTe r C .
. U
Type and Dimensions of Project t\\1 *I N i-S N ....)ce O -gjtl_'?1 � FAC
t ACt 1 iV t ".)
N.s f A L LAT cv F t' -KJ .f I 0 i4� .1 C'S - C)C�C, / '5-A FYI •
I )i rvvet,i<.i cY\ h G, e X 1 e,-ri Kir c LC) Al"
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: 1' _ )
K3 f' _ CI-4 N r A N
f
— i Itc, --
f6' f; c�E 1= -Y\-n . c
,
pe42 - ,C, E t \. IQ .
ikapl T1 L t-tS c:R. Cxr)0 NISI 9 I
X
VI - Co NTt4c-1 G�R-46 HT , be N.
0
-
IF - .d T.?,'-)), rr kL Lt
•
r( l•m,t s.
Any person who proceeds with a development without the con- '4.4 4 I ki C,l 1 it
sent of a CAMA official under the mistaken assumption that the Ap eant'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 signature
ii i I — OC.)
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 e2 1 7 - v

� � / // ?
)
, az,_:„
-- -
_ _
I
cviti Old
r
- 9,02Cdi\a03 d
-a
ifiow9v1/200g
1‘421
E • _ .
4 ,71 g X,19 0
—S— - • — -----i--- 1 . — p
6 — . o • • o •
(/M7
174/0 `9rn y

EPnM !.�`,bjILC:x, TR. Fa>i Na : 910-791-0202 Nov. 15 290E ee:41PM P1
B & K MARINE CONSTRUCTION
Piers • Floating Docks • Rulkheacls •Aluminum & Oakanized 1ivailiRs,
DWjSt�?ti OF_COASTAL MASAC,FMENT
ALLIACENIELIZARIA!MilarartaminamITf1IC ATIONAV IVER
FORM
Name of Individual Applyingfor Permit
'n�s L =7rJT1�1 � f37i�/'I
Address of Property .2 V' WA/AL-±:l
(Lot o *, Street or Road, City and County)
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, whit dimensions, should
he provided with this letter.
I have no objections to this propoea,
seed,p11e ..write the Division of
taaftaBliknagemeilLar_cardinas1nn. Wilmin ann.North Carolina,
e nsiciered the same es nr, Serio iL tl. _bY s ar ltiial�.
WAliusR,fTION
I understand that a pier, dock, mooring pilings, breakwater, boat hove, lift or sandbags
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 plank below)
_ I do wish to waive then 15'setback requirement
I do not with to waive the 15'setback requirement.
!t ! I \--5--CE)
Si -Lure Date
t+Z . ç tv� s h r CQ -° S'' �
Print Name
Telephone Number With Area Code
1319 Military Cutoff Road 6 Suite 106 • Wilmington, NC 28405 • [phone]

B & K MARINE CONSTRUCTION
Piers • Floating Docks • Bulkheads •Aluminum & Galvanized Boatlifts
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER
FORM
Name of Individual Applying l n for Permit: S
Address of Property: 4Y 7A /3/1/1
Wr A 25X' 4/ 47Z ;,0C?
(Lot t 1 ��reet#, Street or Road, City and Count
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 ltter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington,North Carolina, 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 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 do not wish to waive the 15' setback requirement.
COtt ///, d°
Signature J Date
,1 tv r o weovs 2 .
Print Name
ci 16 - Q lf7
Telephone Number With Area Code