Braswell (2)

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 De- , H e P, LA 6-4 Phone Number ''%2- 9712
Address — 6 AV,: z tti ii, E- D.4 e
City State N C Zip r' ,3e
Project Location (County, State Road, Water Body, etc.) :33 T P t! I d>,� r „��A
7--7el•Fi v vi el rf9.rA/ ✓s c /'o.
Type and Dimensions of Project fc'.96,.,If'cs /14, ' �, f r.x,s,/ ,.} rh[ i� A ,.,9d
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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: 30 ' )
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Any person who proceeds with a development without the con- `�/(i ¢
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sent of a CAMA official under the mistaken assumption that the Applica(Vs gn ure
development is exempted,will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development. CAM icial' ignat
eY
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 S

D;vISIQN Of CC? STkL MANAGEMENT
IPAAIAN PRQFti'R�,'Y OWNER 'WsI'r'R FOR'
Name Of Individual Applying For Permit: 5,)DA i,Ji 2r '¼J-ei/
Address .Of Property: r�� /j � r� - -
(Lot or Street 0, 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 objections to this proposal.
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WAIVER SECTION
I understand that a pier, dock, mooring pilings, traakwater, boat
house, lift or sandbags must be set back a minimum distance of 15'
from my' area of riparian access unless waived by me. (If you wish
to waive the setback, you T,ust initial the appropriate blank
below . )
I do wish to waive the 15 ' setback requirement_
.,..__._� Igo no% wish to waive the 15 'setback requirement.
S igna-ure Date Arn
Print _tam'e
TeiepiZnns Number W1tA Area CodeNI FR

DIVISION OF COASTAL M. NAGE%TENT
ADJACENT RIPARIAN PROPERTY OWNER NOTI-ICATION/Aa V R FOR''
Name Of Individual Applying For Permit: 2 "1
Address .Of Property: / 3 7()/2e, II,I
(Lot or Street j#, Street or Road, City & County)
- I hereby certify that I our. 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 drawingy - with dimensions,
should be provided with this letter.
I have no objections to this proposal.
If You haveQoblection.s to what is beir.a orcoosed, o?ease write the
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�, �:�_ a GI _ naton, Nortti Carol a 284C5 or ca l 910 3g-. 39CG wit' to 10
days of recut of this nctice . �No r?soonse is considered the same
as no obiecticn if you have been notified by Ce:tif5ed Mail
WAIVrR SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
house, lift or sandbags must be set 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.
na .:re Cate A: •
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Print Name �•.,. ....•�
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rf:;01-11N.IR
Telephone Number With Area Code