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• 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.
Applicant Name Rob( (-1J. u'v+ r'1 n `tom LAr3 -1,Ic.>s: 1141w,r• Phone Number t I 0— .cl(r. - j(.,D
Address t 1. 7 1\)ovt h t . , k
City ' C t t\, State NC Zip AL - 5
Project Location(County, State Road, Water Body, etc.) 'IC-7 j iti V , _( -c- C'_k i \/ (-1TcNIC.:•,N CC) .
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Type and Dimensions of Project ?-,L,l i_V..i r.. a
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- ;l(i��%�1��
sent of a CAMA official under the mistaken assumption that the Applicant's signatu e
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 /25----'r_r_.
The applicant certifies by signing this exemption that (1)the ap- `1 development
Issuing date
plicant has read and will abide by the conditions of this exemp- - e/ �,lU
tion,and(2)a written statement has been obtained from adjacent D (J

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NORTH CAROLINA 2 8 4 4 5
DIVISION OF COASTAL, MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION
Applicant's Name: o 1 . lah.t.l
Address Of Property: rt N.AN. S� c ��- 44 _Suck (A\;` OAS\ok4.)
Street#, Street Name, City & Bounty
Applicant's Telephone Number 9 16 "116- a3
I hereby certify that I own waterfront property adjacent to the above-referenced property. The
applicant has provided me a drawing, of the the proposed development. Please initia;the
statement below if you have no objections to the applicant's proposed development. Initialling
this block does not constitute a waiver of the required I5'setbackfrom the riparian corridor
lines.
I have no objections to this ro osal-
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Signature Date
IAJ( e�3 44~f C. r4,S ( & Gt�f r to w, l�C
Print Name and Mailing Address a �rf-
Telephone Number With Area Code
If you have objections to the applicant's proposal, do not initial or sign this form. You should
contact the Local CAMA Permit Officer listed below as soon as possible to register your
concerns:
Telephone:
I •�_Sy�iu:.�'-'S •.•.�-yrr. �•-::.+=-Jw _.T ..�«era--.�,.. -. �_.�._-«.. ..�
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Box 2475 • 214 N. New ('liver pi ire: • T I phone (910) 3C23.4131 • FAX. (91O) 328-4132

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NORTH CAROLINA 28445
DVVISION OF COASTAL NIA:NAGEKENT
ADJACENT RIPA,RZAN PROPERTY OWNER NOTDF1CATION
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Applicant's Nye: uj n - 6)`••••,.
Address Of Property: 9013 ; n k 4rec•k S�rA. C-i OA 'ot�
Street#, Street Na/ne, City & county
Applicant's Telephone Number /G d 3
I hereby certify that I own waterfront property adjacent to the above-referenced property. The
applicant has provided me a drawing of the the proposed development. Please initial the
statement below if you have no objections to the applicant's proposed development. Initialling
this block does not constitute a waiver of the required 15'setback from the nparicai corridor
lines. •
A.—have no objections to this proposal.
Signature Date q
,,LJrllia, \ 2� Q,-trr.� fi. r�x�NsU% tit
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Print Name and Mailing Address
(916) D-cUe Or? C(Lf
Telephone Number With Area Code
If you have objections to the applicant's proposal, do not initial or sign this form. You should
contact the Local CAMA Permit Officer listed below as soon as possible to register your
concerns:
Telephone:
` -�.z, - +'- _ ,. : +�`"' _ .r-� * 3o-:'" "=` ids::'.^3•,.