Ward (5)

-•!r�'nw-rres.n..�cy rgr-,�-.�.a.e-...e:-�sv:.,.xrrn.a,........- .. .._.. .. .�.-�-.;.-.
CERTIFICATION OF EXEMPTION
\.Z. ----
,r,
i. „,„ i FROM REQUIRING A CAMA PERMIT
\ � '7 Pr
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 K,C kNl W errd Phone Number .
,..f _1O (ai u
Address 82 3 cs.r-Lcif- "Ta-,., tip, IU .ulAct i
City L 0. rr, bc-r i-a State C Zip Zv 35 t)
Project Location(County, State Road,Water Body, etc. 't k,,n s I..J IC k--- c O LA-r , 1 2(1) -((,.4)1-,
c1 \- warp N tukAr\- 1,A6c)v fir,A \
Type and Dimensions of Project 11 u t tL t -n ci j t — -5 rty c ,IA 1 ct l F1 C�--� � n m e--nrt
So' LOT
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: iv U-, )
ic
IE.X*is4',P\rA
0
i 1
i
. _ ._ _._ _. _ J I
1 -13,1„\‘':.-1-\ 8 41A re.n, ,rt /
P
/t,�/ b
Any person who proceeds with a development without the con _ 1(; �__
sent of a CAMA official under the mistaken assumption that the Applicant's signature
development is exempted,will be in violation of the CAMA if there �- i' — 1
is a subsequent determination that a permit was required for the
development. CA Official's signature
CI 2 UU U
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 n(k,,,c4, <O iZ Un I

A
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
FOR CONSTRUCTION OF A
BULKHEAD
I hereby certify that I own property adjacent to 1( wsp
A4
property located at S TO (- ;c- L -
(street address ,
on a man made canal in the Town of Holden
lot no & subdivision)
Beach. I have no objection to a BULKHEAD being constructed at this
location.
r
--21Z
Adjacent property owner o ! eztA
Signature
i\• f2 ( -rho i14 Sot)
Name (please print or type)
Adjacent property owner
Holden Beach Address
Home Address
City, State & Zip
CAMA requires property owners signatures before general
permits or exemptions are issued. CAMA's Wilmington Regional
Office address & phone number is 127 Cardinal Drive Ext . ,
Wilmington NC 28405 , ( 919) 395-3900 .

NOV-08-00 THU 12 :05 JOHN STAFFORD DESIGNS 9108558323 P. 01
til 4/2 -
, li,.?/ .
uratratagzszmiatuljuurjadery TxricA,Tios
DA�UJ►1'I
AD3ACOI
2.
( 0 i__L4,-.- --"--"`""'" .. "------ --.'
apptiotnt'►Naas... �:. 4
r.. C.ountY
Addrsrce Of Property. Sven!M. Stunt Nan*
Agglfrtnt's Telephone Number
•
ed aq�Y. 7�
certify that 1 owl Warfront prop+'&event to the ebovMe 'ate
1 here ' of the the proposed dril . Plats iaitil►l the
,�Pbr„r't has C► u be+4 no Wactione to the applicant's propoesd dovoloptnent, benorrir►t
sown, slow i!you rite re ired J S'setbacksetbackfrom the rtp�R"corridor
thist blockxta2 Cers3'tute a wciwr of qw
lines.
1 have no ob?totiona to this proposal.
�.. J g
Date
Si. ,ute
. . wets 14-C•5.1053a'
Print Nernst and Meiling Address
Telephone Number V►Ith Area Code
If you have obleotione to the applicant's proposal, do not initial
n t alor sign this form You yoshould
contact the Loci: C A.MA Perri;Moor listed belowa potato
r
canoetnt;
• .
1elePhane;
4W.0111 U P D4 Ao x vttitI 60•9s -440l
ro•ti