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HomeMy WebLinkAboutDock 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. - "1Z,C1( ,.‘ V.JI11A � S Applicant Name '+.)c rt` dL1 P. L 11sSUc- • Phone Number CO 09,52. Address I . 0 . -Noy. City I d State j\j Zip ?lb[o Project Location (County, State Road, Water Body,etc.) r u ' J, Co u - - 1D. UGC S',d v^c1 h S toff r1 (� c e-•tN \ -T s le e a c ►^ �1r o C-1" of P z tJ k) •0%6 4-,()'-k" r k. Type and Dimensions of Project , P! r A-p a r\ s m o r e nc`J `7>' , I t - ' d v)fl r d or V\ t,`J ..,- An6 UJe 1 rid 5 , U e ros,or\ esc q rp r.�+ 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: Cick - -� _ I � II I I fr.(Nt_1 S ,de.� n c u C K- C o Nd 0 S �c�ck fi ,5+ r. -�_', A • � fiu bey t+\A,t��'A,r•�d via Any person who proceeds with a development without the con- A 6-t- - sent of a CAMA official under the mistaken assumption that the Applica is signature QC)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 ial's signature The applicant certifies by signing this exemption that (1)the ap- Issuing dat plicant has read and will abide by the conditions of this exemp- tion,and(2)a written statement has been obtained from adjacent Crt564-� 075 �C UC)6 • _, ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I herebycertifythat I own property to -5 /e t )1'4 's P P Y adjacentI / Wet I / (Name of Property Owner) property located at • ►���/ Wet !y V (Lot, Block, Road, etc.) on C OCi/11 /> , in O L W , N.C. ( aterbody) (Town and/or County) He has described to me as shown below, the development he is proposing at that location, and, I have no objections to his proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (To be filled in by individual proposing development) 4-- G)frf gk çOh gnature A/410j ADO E-ull Print or Type Name 3 - igf Telephone Nu mber Date: ✓ ! " -29- ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I herebycertifythat I own property adjacent to atAj 1 ram' 's J (Name of Property Owner) property located at ( (Lot, Block, Road, etc.) on fd &G0-1 ( / C , in Z--1 , N.C. (Waterbody) (Town and/or County) He has described to me as shown below, the development he is proposing at that location, and, I have no objections to his proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (To be filled in by individual proposing development) Signature A)//44-nq Print or Type Name 'G/ 2- o9Yz Telephone Number Date: 06 -29-