McGinnis

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 )�bke
r -r- i� C /A /1' , Phone Number
Address 5 5 / ► l n^ v r ( /a�c (
City F� t' , r State AA- Zip a $ 7/
Protct Location(County, State Road, Water Body, etc.) mA r , �' -4 . (' r r-/
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The proposed project to be located and constructed as described This certificatiorf 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: /vo'f'I; 9jc, ({ )
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Any person who proceeds with a development without the con- s- � - (7';;' ,ei f - ,v
sent of a CAMA official under the mistaken assumption that the Applicant' I ature
development is exempted,will be in violation of the CAMA if there ,_ ,Q ^
is a subsequent determination that a permit was required for the >
development. CAMA Off' ' s sig ture
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 f — Pk —1 CI

Brunswick. business 5er%ic,
Printing ;• office Supplies
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e-mail [e-mail]
Thank Qau Fat Clow Business
Shallotte Southport
754-8300 457-4565
Fax [phone] Fax [phone]

^ . .
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Certified Mail
Return Receipt Requested
------------------------ Date: _-/_--�___�__-_
ear �\«" -� :
------------I
--
0),letter is to notify as an adjacent riparian landowner
of Mr. /Mrs. Mr, _ plans to co t _
on their property, y"�. �Yl~"[�� �'\ in
The sketch on the reverse side accurately depict the proposed
construction.
Should you have no objections to this proposal , please check
the statement below, sign and date the blanks below this statement and
return this letter to: GRICE CONSTRUCTION 6618 BEACH DRIVE, SW;
OCEAN ISLE BEACH, NC 28469 as soon as possible.
Should you have objectives to this proposal , please send
your written comments to: NC DIVISION OF COASTAL MANAGEMENT 127
CARDINAL DRIVE EXTENSION; WILMINGTON, NC 28405. Written comments
must be received within 10 days of receipt of this notice.
Failure to respond in either method within 10 days will be
interpreted as no objection.
Sincerely,
-
�
I have no objection to the project as presently proposed and
hereby waive that right of objection as provided in General
Statute 113-229.
_______ I have objections to the project as presently proposed and
have enclosed comments.
__L '
Sign�ture �/

. . ~
Certified Mail
Return Receipt Requested (�
�� [\
Date: _���� \ - - _i_
T ett i ify as an adjacent riparian l downer
of Mr. /Mrs k_ l s to co \\u J
/ \�~
on their property, l\\o^c�j�_������ � in �_�^�����
The sketch on the reverse side accurately depict the proposed
construction.
Should you have no objections to this proposal , please check
the statement below, sign and date the blanks below this statement and
return this letter to: G R I C E CONSTRUCTION 6618 BEACH DRIVE, SW;
OCEAN ISLE BEACH, NC 28469 as soon as possible.
Should you have objectives to this proposal , please send
your written comments to: NC DIVISION OF COASTAL MANAGEMENT 127
CARDINAL DRIVE EXTENSION; WILMINGTON, NC 28405. Written comments
must be received within 10 days of receipt of this notice.
Failure to respond in either method within 10 days will be
interpreted as no objection.
Sincerely,
_ .,_ . I have no objection to the project as presently proposed and
hereby waive that right of objection as provided in General
Statute 113-229.
_........................._ I have objections to the project as presently proposed and
have enclosed comments.
................................ ........... ...... ___
Signature
^~ -

^ '
WWI-
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: J��\PY~'�__�-
\
Address of Property: e---------------
y\_\�`� _r�[�Uo7
(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 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 objectives to this proposal .
If you have objections to what is being proposed, please write the
Division of Coastal Management, 127 Cardinal Drive Extension,
Wilmington, NO 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 sat 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.
_ ______ I do not wish to waive the 15' setback requirement.
_________________ _______________ __________
___ ____________________________ ___________________________
y /\\(R
��k__��_
Signature - � Date
___ p � _ _____
Pri _
nt Name
cy
Telephone Number with Area Code

^
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
. `
Name of Individual Applying For Permit:
\ \
Address of Property: _ L�� _ \ ) \Uf\��
��r\
_''______'�T� � ��____��-��_���_'�__
(Lot or Street #, Street or Ro�d, 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 objectives to this proposal .
If you have objections to what is being proposed, please write the
Division of Coastal Manag(=..ment, 127 Cardinal Drive E: Lension,
Wilmington, NC 28405 or call 910-395-3900 within IC) 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 sat 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.
I do not wish to waive the 15' setback requirement.
��_
Si ure
Print Name �
�
_=^ �__`-_�__=_� - ________________
Telephone Number with Area Code