Hill

,f 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. E�wti_jX�.
Applicant Name T?.ogkr+ N i Lk_ C/o C kirl ta, -1�J- ert Phone Number 'no)4S7 cA-PA
Address o 14 1,0
City T c i fr- c 1( State tJ : Zip ?-P (.S
Project Location(County, State Road, Water Body, etcc.) SA.„„4,_ 44--j Ptn �}cs
ASww 125rit LIS 1� C o ,
Type and Dimensions of Project t� °tom Pt-0 C p r 04. 1 C
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: )
t---- CA)
•
4/
la-
- - 1Z- 4 �
t y. f
Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assumption that the tftur4_,
development is exempted,will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the C)1J
development. CAMA Off ici 's signature
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

I
The American Fish Company
didisA.tink„,t P.O. Box 11046..): P. '. - [phone]
Southport, North Carolina 28461
T
II I
i ..\ ;'!iiiiik
,‘ `% '
14
.: 1
� , i
� • • 1
'' A? s
ft... ;ram
• ss
ift
l w
V
►1 /•- 1

L L. UN of COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIDN WAIVER FORM
Name Of Individual Applying For Permit: /4► . 1` /jry
t .
1 . /l
Address Of Property: 1? e 'f _ ¢ /2
c
C stir �� / �'� • u-i S
Lot or ¢ St eet of Road, city & County)
I hereby certify that 2 ownproperty referenced property. The individual applying adjacent to the above-
described to me as sho for this permit has
ire ro o= ,.Finn t -tt-a-eh-ed- ing—t-fie development
they P P ing. A description or drawing, with dimensions,
should be provided with this letter. ion ,
I have no objections to this proposal.
If you have objections to what is being proposed please write the
Wilmincton , North Caroling . Carding rive Extension .
days of 28405 or call 910 395-3900 within 10
receipt of this notice. No response is consider
as no cbiection if you have beened the same
notified by Certified Mail a.��e
WAIVER SECTION
I understand that apier, mooring
house,
liftdock,
must Pilings, bre�k;aater, boat
from myareabe set back a minimum distance of1 '
of riparian access unless waived by me.
to waive the setback appropriate 1
below. ) , you must initial the (If you wi-
-h
b_�nY,
I do wish to waive the 15'setback requirement_
I do not wish to waive the 15'setback recuirement
Date
1 �
........
•
U
4,1
Telephb:,e Number With �' '7- 7�j
Area Code

ulvll011 OF COASTAL MANAGEMENT
ADJACENT RIPARIAN P OPERTY OWNER NOTIFICATION WAIVER FORM
Name Of Individual Applying For Permit: T t'Ir_s . 9
Address Of Property: /
Lot or /Street #, Street or Road, City & County)
I hereby certify that 2 own
above-
referenced property. The individual applying
to the described to me as sho PP Ying for this permit has
y are prop 'y'A-Dn.-the—att-aehed-=dYawingffie development
they
g. A description or drawing, with dimensions,
provided with this letter.
I have no objections to this proposal.
If You have objections to what is being Proposed please write the
ivision of Coastal Manaoement, 127 Cardinal rive Extension .
Wilmincton . North Carolina , 28405 or call 910 395-3900 within 10
days of receipt of this notice. No response is consider
ed c
as no objection if You have been notified by Certified Mail
_ amE
WAIVER SECTION
I understand that a pier, dock, mooring
house, lift pilings, bre_kwaterboat
must be set back a minimum distance
from my area of riparian access unless waived by me. `If y of 15 '
to waive the setback, you must initial the appropriate `h
below, )
blank
I do wish to waive the 15'setback requirement_
I do not wish to waive the 15'setback requirement
Su
icni`/-- 1211 ,7 q1 q
P.� - Data
-J ls_ / K/?S • .
Print Came
Telephone Number With Area Code � ANY R