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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
0 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.
7toApplicant Name H a is l� , I sc.,..",, /
i 1 ,.,,,.a,,,; t,--c.L) Phone NumbeL `�(
S 0241' -2(=64
Address PO `b l
City m q.f- s v, 1le-- State tJ C Zip Si 03
Project Location(Coj,nty, State Road, Water Body, etc.) 2i I �T ,
Pin kc. . D A Vi < r it't-s At_ R -c t,,e-s.�... . C0 .
Type and Dimensions of Project P..e Pl A-cQ y Cam. ' - r.,xr c,.1
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The proposed project to be located and constructed as described This cer i ication 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.
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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 Applicant's si
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 Offici�a''s s' nature
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The applicant certifies by signing this exemption that (1)the ap- Issuingdate
plicant has read and will abide by the conditions of this exemp-
tion,and(2)a written statement has been obtained from adjacent 7/

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Coleman Docksworks
P.O. Box 222
Long Beach,N,C,28465
Phone: [phone]
Date:/2-yr
B `� c. eT'c C 01.1
3 sch rUo.t .
RE: 1e �i ��� Foie. AQP �ntSet- t aUS � . �. �� qa
Ch (es w.ISo.� cw w3c4— 0.c Lam.
Dear Sir: •
To Satisfy N.C. General Statute requirements for CAMA Permits adjoining property owners must be
notified of proposed waterfront construction and given written certification of such notification.
I would like to inform you of the proposed ck 4_ Ft A-,Ads D k' for the above
referred lot. If you have any questions please call my office Phone [phone].
If you have any objections please send them to the following address:
DEHNR
127 Cardinal Dr.
Wilmington,N.C. 28405-3845
If you have no objections please sign this form and return it in the self addressed stamped envelope
provided within ten days.
Sincerely,
egel.A.: CZ,
. A Cheryll G. Coleman
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pgnat j
ElI waive the 15 foot riparian set back
�/f do no waive the 15 foot riparian set back

Coleman Docksworks
P.O. Box 222
Long Beach,N,C,28465
Phone : [phone] lR
Date: _ Z _C)
RE: c rC r—t �V� MSS °�4�c.�`2s CJIJ.( s vt)
06 L . r fP="ic
Dear Sir:
To Satisfy N.C. General Statute requirements for CAMA Permits adjoining property owners must be
notified of proposed waterfront construction and given written certification of such notification.
I would like to inform you of the proposed Doc(L (/o4'L1,., D cc< for the above
referred lot. If you have any questions please call my of ice Phone 91`6-457-1724.
If you have any objections please send them to the following address:
DEHNR
127 Cardinal Dr.
Wilmington,N.C. 28405-3845
If you have no objections please sign this form and return it in the self addressed stamped envelope
provided within ten days.
Sincerely,
Cheryll G. Coleman
Signature
I waive the 15 foot riparian set back
no(-waive the 15 foot riparian set back