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Home My WebLink AboutRozycki Pr CERTIFICATION OF EXEMPTION FROM REQUIRING A CAMA PERMIT as authorized by the State of North Carolina, ha 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 /JE4/ N A o YC K r'/ to 1346 +n1,1 i(A`A5 Phone Number 7 /0) 3`1 `7/U Address 7;3 5 y4 rr ✓voD LAA/� 4r07"- ?,o City L.;/ell N<' ^- State ,V C Zip . a 4// Project Location (County, State Road, Water Body, etc.) P, - f1 )_ . .=...-f-c �. r=-E-. /` -. /-h^ Co Type and Dimensions of Project 62, ✓a te. P, ("r_ y ' X 70 ' 14- , r- Li r){/-) ' Z ` Pilie4 13 ' 4. 4/l (04ty-r,',/r r of ?k .&Jo 3 .SUM" ASP/t/ 64 #e0 '1F f/ �'4114(7' s-/rc' 4 J Ifl t �n u.- 3 6" 440Y�* 546$ c'4 t o � C6Af74:0 l vtsd74A1,D e 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: e *71U ) -- �.(A— z' /--/ ( /' /l — it si (U w tl�nfJr �.11 � V v� '� C 04' 46 C tf I vil 514l?'W&U+) L, -' Any person who proceeds with a development without the con- b lit%/,//•----� sent of a CAMA official under the mistaken assumption that the Applic nt'signature development is exempted,will be in violation of the CAMA if there t I i - is a subsequent determination that a permit was required for the development. CA ficial's signat e The applicant certifies by signing this exemption that (1)the ap- l 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 ) H DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM • Name Of Individual Applying For Permit: /401../-rJ 0 Z-"y C Address Of Property: 9;19s" 3) 0 k(g rz % *3 v) 6/ (dzi/ 76T A 1 A<C c2f57// (Lot or Street #, Street 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 Pie as shown on the attached drawing the development they are proposing. A description or drawing, with dimensions, should be provided with this letter. N I have no objections to this proposal. If you have objections to what is being proposed, please write the Division of Coastal Management, 127 North Cardinal Drive, 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. )00( I do not wish to waive the 15' setback requirement. Sig atg Date Print Name N C D E R Telephone Number With Area Code NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES 1 -08-1 999 3:3dPP1 FROM I MAG I PIED I A 81 87350301 P. 1 =ROM :MAIL SOxE$ ETC eZ775 010 6E96 7031 195,01-oe 19:67 124c3 P.03 DIVISION_OF COASTAL MAN4GEMF,NT 4CEN U RIPARIAN PROPERTY OYCSTR NOX1 ADONIWAIVER FORM e Name Of Individual Applying For Feruiit. /46k4r4 C ` E Address Of Property: ?%— 524-Lra/0 0 c (e 2c/ *3 0) c</i 9/, ?a nl , A(C f t( (Lot or Street#, Street 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 tote as shown on the attached drawing the development they arc proposing. A description or drawing, with dimensions, should be provided with this leafyI have no objections to this proposal. If you have objeL bone m what is being_pr cserl lease writP`fhe Divicinn of C.oacral Management 127_North_.Cardir Drive W i1mi _ 393Qwithin 10 days of rereipt of this nr> Nn response is ronsidereri_thesame as no objection if you have been notified by Certified Mail WAIVER SECTT1O I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be set back a minimum dism.tx of 15' from my area of riparian access unless waived by me. (If you wish to waive the setback, you a►usr initial the appropriate blank below.) I do wish to waive the 15' setback requirement_ }C(>c I do not wish to waive the 15' setback requirement. 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