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/` � 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 VJ ALTO -- i+ c u k. '/c� �r reU a Phone Number ',cif 0)20( -440,1,
Address c4( O E Pei D .
City State N Zip 26
Project Location Cotinty, State Road,Watei Body, et;.) S
1C` vY� - r u a s tN t �2. C.i .
Type and Dimensions of Project '• iV •
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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: = 20( )
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Any person who proceeds with a development without the con-
sent �_.�✓"�
of a CAMA official under the mistaken assumption that the A••t,<-n's s)gnatur
development is exempted,will be in violation of the CAMA if there �_,4_ \ ��
is a subsequent determination that a permit was required for the )
development. CAMA Official's signature
The applicant certifies by signing this exemption that (1)the ap- �4 —�
Issuinte 0.4 _9
plicant has read and will abide by the conditions of this exemp-
tion,and(2)a written statement has been obtained from adjacent
Coastal I ockworks
PO Bo r 10671
Southport- N.C. 28461
(910)-s 15-8687
Mr. Douglas Stephens
9030 US 158
Stokcsdale, N.C. 27357
Mr. Stephens,
Enclosed is the adjoining property owner iu• ication/ waver form required by CAMA to
obtain the necessary permits to construct a c' k for Walter Hitchuk at 2620 E. Pelican
Dr. Long Beach, N.C. We plan to construe t Jock app ox. 25 feet long and 4 feet wide
extending 8 feet beyond the marsh grass int( Davis Creek (see attached drawing). Please
sign and return the form to me if you have it ) objection to this project. If you have any
concerns or comments about this project ph contact me or
E. F. F OOKS
ACTING LOCAL PERMIT 1' FICER FOR LONG BEACI
127 CARDINAL I:' 'WE EXTENSION
WILMINGT' N.C. 23405
Thank you very much,
Greg Prevatte
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DIVISION OF COASTAL MANAGEMENT
ADJACEJT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER_ FORM
Name Of Individual Applying For Permit: // �,
WAli6r H;k4,4,1f
Address Of Property: 2.6 026 E. PeL;c4h
(Lot or/ rupz14,:cir 66,n't?
Street #, Street or Road, City & Count )
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 povided with this letter.
✓ I have no objections to this proposal .
If you have objections to what is being proposed , please write the
Division of Coastal Manaaement , 127 Cardinal Drive Extension
Wilmin'aton , North Carolina . 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 must be set back ' a minimum distance of 15 '
from my are:: of riparian access unless waived by me. (If you 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.
•
•
X / R A 113 (q1 .A,
Signat e D=teI
Print Name ,-��», r
Telephone Number With Area Code . NI
•
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER. FORM
Name Of Ir.c ividual Applying For Permit: fei, V 1-Ch ui1 _
Address Of Property: 24 26 C. PPL;C4►1
Zoe 6e461►, l�G 2544 ) r�hSw:cn Ccv•,7j
(Lot or'Street #, Street or Road, City & Couni:7)
I hereby certify that I own property adjacent to the abov,3-
referenced property. The individual applying for this permit has
described to me as shown on the attached drawing the development
they are r r oposing . • A description or drawing, w t^•
5i1ould be r) -ovided with this letter.
yine. /I have no objections to this
proposal .
•
If you have objections to what is being proposed , please write t'-_
Division cf Coastal Management , 127 Cardinal Drive Extensic .
Wiltington. , North Carolina . 28405 or call 910 395-3900 withina0
days of receipt of this notice. No response is considered the sa;Te
as no ob17:;lion if you have been notified by Certified Mail
WAIVER SECTION
I understac: that a pier, dock, mooring pilings, breakwater, boat
house , lif must be set back . a minimum distance of 15 '
from my ar, a of riparian access unless waived by me. (If you wish
to waive 1.e setback, you must initial the appropriate blank
below. )
I do wish to waive the 15'setback reau i rement.
I do not wish to waive the 15 'setback requirement.
•
na ure //
Si
g Date 'A • '
04//,A,
Pr ' t N�a a
Te ephon4 NEi. ber With Area Code , ®� N