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r CERTIFICATION OF EXEMPTION
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1 - ,..:Ir 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.
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Applicant Name Liu' t,S ('f1i- ., Phone Number n?,j of -5 3- 735/
Address 'OUS A/ fY-erf-
City n rf Cdvi State Zip 07
Project Location(County, State Road,Water Body, etc.) S/ndei- G -nft�� , �17 M. iVeAAJ kiwi,-
brd E.,, _-Surd C'.11 , A fr-r'S ,( A9
Type and Dimensions of Project iCe#r,'(';nc, WA ii / $u 1 kI& MS , ( � f, 0d� d o
/c op14 cr\r� F r (\1^ 'knot- i3ee -1+ cDf 1(,:i �' 1\ fed cle 1
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The proposed project4o 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 Locai authorization.
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Any person who proceeds with a development without the con- t-,,,, A 1L...ei �
sent of a CAMA official under the mistaken assumption that the Applicant's sig e
development is exempted,will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the �( Y =x--
development. CAMA Official's signature
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The applicant certifies by signing this exemption that (1)the ap- �� t t
plicant has read and will'abide by the conditions of this exemp-
Issuing date
tion,and(2)a written statement has been obtained from adjacent C 9
r q''`` • SA:ID DOLL DOLLAF PEAL ESTATE, IN:. PHONE N
• '- 910 z�?t3 00'7. Mar. OS 1999 05:51Art P_:
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arasit bE COASTA A NAGEMENT
-__ ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION
--- ______--.- _._ —_ -
Applicant's Nana:: ; ,�.ii. i ra y
Address Of Property._ S+2 ,q,/ P -, i ' �Y
Street ii, Street Name: City-&
Applicant's Telephone Number 515;4-,32 3-7;-;7
I hereby cerrfw that I own waterfront property adjacent to the above-referenced property. The
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applicant has
1,prn ed mg,a rawir�of the the proposed dcvCjopTelIt. Pie3 l the
t ink.
I) iI you have no otjectlions to the applicants proposed development Initialling
this block does not Constitute a'wa?ver of the required f 5'setback from the riparian corridor
Imes.
'/I have no objections to this ro os
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Si iatu-e I- Date AA
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Print Name and Mailing Address
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Telephone Number With Arca Code •
If you have ebiec:tions to the applicant's proposal, do not initial or s:gn this form. You should
contact the Local CA\IA Permit Officer listed below as soon as possible to register your
concerns:
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01 • //..rrf;A'.t if;Irisrr Fit 4-r.4.z,
Telephone:' 9/e, - ,c c-,Ii4
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P-. Box 2475 • 214 N. New River Drive • Telephone (910) 328-131 • FAX: (910).323-4132
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7 �(-.w•C^ X- NE'-VA A.A\3WAY u.•CP Poor.
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ORIw NORTH CAROLINA 28445
prvzsroN OF A TIIJ hANA.QEMENT
AD3ACENT RIPARIAN PROPERTY OWNER NOTIFICATION
Applicant's Name: C ul ..Df' ke
Add."ess Of Propel' 'l'7 ./, /Sl-r,f .e.�r'�rr'��i`.:.�; ,xtif . ./! ,G' ; c}►� r ae 1'
Street #. Street Name, City & County •
l;l c� Numbe: ) y�/
Ap i..ant s Telephone �,$ -,ya23- ��
I hereby certify that I own waterfront property adjaoent to the above-referenced property. The
applicant^-as^-ovided me a drawing of the the proposed development. Please initial the
s:aternent below if you have no objections to the applicant's proposed development. Initialling
this block does nor co.zsrit ze a waiver fifth required IS'setback from the riparian corridor
lines.
I ) ; :JI have no objections to this proposal.
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Print Name and ailing Address
Telephone Number With Area Code
If you have objections to the applica•.1t's proposal, do not initial or sib this fora You should
contact the Local CAvIA Permit ()leer listed below as 3oor as possible to register your
concerns•
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Telephone: e_ 79a-3 9,1”
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' - - rRa} Sox <<.;S • 214 N. New River_Drive • Teiepnon= (210) O28..41 5.i • .FAX, ,9?C; $29-47 32
TOTAL P.01
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