Whitley (3)

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 envi onme tal concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name V . C. W Phone Number
Address.' Vi 0 OCPy A g/'J I h,
City ( 6T���• State Zip r6,4,
Pro' ct Location(Co nty, State Road, Water BQqg�y,,,ee'�c.) iO C e K v (,) , j�I4 c
-o / IfltKde C4na I Opt Hcal��„ g(�� 1, i� $r .n ) 1v1� k CpJY� 1
Type and Dimensions of Project > + . C.XI SI i A 1 4I^ 4 7)c kAJ I J- L(
r S4, P $/ZC oJ�c �c t�'' N -1- at'i i►� h S/o�,) Q► h 6 i r, r. e u S c r P
ye / + S e T 6 C{(... 1�.
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:No4 7 S c y'e
N
b
!- X tgliA F✓'kiln ,
Any person who proceeds with a development without the con- C
sent of a CAMA official under the mistaken assumption that the Applicant's signatur
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 Of is s 'gnature
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 `? "�

Y
0t 1iS:O'( OF COAST'?. H=.P'AG„".NI:
AD•:AC?N"_' ?=?? :A:1 PR0???.TY OwfZ:? NOT_7:CAT:ON/:.n:7=R TO?m
Name Of Individual Applying For Perm__: JJ , C . Iih 7'1e
4
Address Of Property: god BJo J ' ecer i? Ll
!1/4/ n) a -
• (Lot or Street 0, Serest 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 me as shown cn the attached drawing the development
they are proposing. A description or drawing, - with dimensions,
should be p_ov_ded with this letter.
t I have no objections to this tropcsa'_ .`�ro'J . �4� °
J�•q�c .er1—gir\ke K ;�, •'rig= c� "' �� �S ko-n % ,5+: Or _-
If you have ob-i ec z ions to what is be i'.':c c-oocsed . p' ea se w'-i to the
Division of Ccas el Manacer-ent . 127 Cardinal Crive Extension .
W lrinctor, . Ncrt^ Carol ` nd Z3t05 Or call g1Q 397-3"�0 w' t'-tin 10
days of receipt of this notice . No resoonse is considered the same
as no obection if vol: have been notified by Ceram:._ Mail
w :vrR s!cTION
I understand that a pier, dock, mooring pilings , breakwater, boat
house, lift or sandbags must be sat back a minimum distance of 15 '
from my area of rioarian access unless waived by me . (If you wish
to waive the setback, you must initial the a... iate_ blank
below. )
"
do wish tc waive the 15 'setback requirement.
I do not wish to waive the 15 'setback re uirement.
S 4.,gnator-a
Date
F r
Vot/e/ d f •
e�
Name
�EHNF
Telephone Number With Area Coda

r
OiVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFI_CZTION/ZYArV?R FORM
'�Name Of Individual Applying For Permit: �e , 1.c��, �ec
Address .Of Procerty: 90 'pq Ceeah Ili U.
p4/ L) / tea<h N. (2 .
(Lot or Street T, Streed t 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 me as shown on the attached drawing the development
they are proposing. A description or drawing, •with dimensions,
should be provided with this letter.
I have no objections to this proposal.
•
If vol.: have ob ec=icns to what is be_nc Rroaosaad. mlease write the
Division of Coastal Mana=ement . 127 Cardinal Drive Extension .
Wi l:,inctcr, . *fort" Carolina . 23405 or call 910 393-290C within 10
days cf receict cf this notice . No r estonse is c:nsi e`ed the same
as no obi?Cti on 1: you have eer. notified by Certified mail
WIVZP SECTION
7 L.nd=rstand that a pier', dock, =coring pilings, breakwater, boat
house, lift or sandbags „gust be set back a minimum distance of i5 '
from ry. area of riparian access unless waived by me. (If you wish
to waive the setback, you must initial the appropriate blank
below. )
/rpt
T do wish to waive the 15'setback requirement.
Y do not wish to waive the 15'setback requirement.
Sign azu,e Date +r
cAb e-s*-
Print Name
wlif Tele hone Number With. Area Code �; �