Dooley (2)

• CERTIFICATION OF EXEMPTION
A
FROM REQUIRING A CAMA PERMIT
_ as authorized by the State of North Carolina,
k' 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 Tironi,a 1 E . D 00tEV Phone Number (,1 1'-.) \ 307-I)v S
Address 6-1.)J LY, k\hR-vf K (SRC 1-C
City -.PA D C Fa/2-V State ,/ C Zip .(S YW,v
Project L9cation(County,State Road, Water Body, etc.) -' A JCS hLQr--( — .F vet(~17`r c geek
0 6-$ (U_- 0o•
Type and Dimensions of Project /et.( 14 !' / An 0 A' r) r-m ci it'l,G N 'I'1 P,.• �/ -"
e0goi• /3 O ' D l
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- nC// ..
sent of a CAMA official under the mistaken assumption that the Applicant's sign re
development is exempted,will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development. A 0 is s signature
The applicant certifies by signing this exemption that (1)the ap- ssuing date
to
plicant has read and will abide by the conditions of this exemp-
tion,and(2)a written statement has been obtained from adjacent . '7(o-CX)

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•
• AD,;ACE DIVISION OF COASTAL MANAGEMENT
Ir'T RIPARIAN PROPERTY OWNER NOTIFICATION WAIVLR- FORM
Name Of Individual
Applying For Permit:
Address Of Pr t l_ ______ f _ . �oour
operty: O LA LL .0
SNal-OS F.c�R
(Lot or Stream Y ,O.0
Low CA
�t t, Street or
Road, City & County)
I hereby cent ' .
rreferenced certify that I own property
eferent to me
The individual applying for
rthe
to above-
referenced are proposing.
shown on the attached drawing r this development
has
should be.' provided with description or drawing, ith developme 1t
•
letter. dimensions,
I have no objections
to this proposal.
•
If you have objections
Division of Coastal to what is being proposed .Wilmington , t'l Management. 127 Card ' pleas write on .
• North Carolina , anal Drive
days n receipt of Ca 28405 or call Extension
as no f rec is notice. No response onsid 00 within
ction if you have been t • is consider l0
__n notified by ed she sar=
Certified Mail
F'P_IPER SECTION
understand that a ,-
Ihound, lift Pie- , dock, mooring , breakwater,
from mymust pilings,
t area of riperian bess set back a minimumtancer, boat
b°i waive the setback, you emustunless
lin 5tia waived by me.distance you 15
l the appropriate wish
blank
I do•
wish to waive the 15 ,setback requirement.I d t wish to waive the u-
15�setback rea �
cement.
P eb E,,r- ,u R p Ho q .
51a—nature 31��2ovo
K Date
Prinz Name
• •Tele �o — ��—3�� -�—Akf
4yro
?hone Number With Are D
=a Code FA N R

ADJACENT DIVISION OF COASTAL MANAGEMENT
.. T RIPARIAN PROPERTY OW
NER NOTIFICATIpN/WplVy� FORM
Name Of Individual A D1 n
Yi g For Permit; 1ioM ? oo Lcy
Address Of Property; es OO W
L(--R0P(4 C1 R. S
NE-RQf F'cagy Ni c
(Lot or Stree �r ,j t_ou: C"
t iq, Street or Road City' C-�Y & County)
I hereby certify
y that I own property
described to property. The individual applying f r to the
as shown on for thisabove-
. referenced Pr . oein the attached drawing t developmentt s
shouldey are posing. A description or drawing, the
ovided with this letter, with dimensions,
I have no objections to this proposal.
If you have objections to what is be '
Division of Coastal �,- ina proposed .
Divisionon . Management. 127 piecSe write on .North Carolina . Cardinal Drive days of receipt of Ca 28405 or call 8 Ems'-'ni ono
days
•
no f receipt is notice. No response 10 3 nside.0 within 10
ction if you have been t • is considere_n notified by d the sam=
Certified Mail
I' fSf1�T/r ZT
•
��ivy1
I unde_sLzn
s''-er, d , mooring pilin
y �` g breakwater, boat
.
from m area _Darien acces hack a minimum dista
to wa; ne setback s unless w nce of i5,
house, lift
L initial the- e.
w. ) You must (If you wish
approprietn blank
•
I do wish to waive the lS'sethack requirement.
I do not. wish to waive the 15'setback reauirema
_nt.
410, / . 0 dg/e°Si. -gnatur
4���/ / Da to
Print Nam. ate! A ' •
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Telephone Number t
Wi`n Area Code F