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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
t 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 '� }>✓V� SAC.0 hS 1- Phone Number U Gam' -3.173
Address iJu6 a,e uJflk CIKb k- trA ' ^'14 44 b I
City 1 r". I� 4 o+s, State Zip oif3 Ni 11
Project Location(County,St t Road, Water Body, etc.) ; Pam' Co L.A t I.-uT N i n,r-
r-oWc__ Po;r\-4 , LU', I in,r\cl-(or\ IJd_.• -Ti-.1,,,,. off A. ATOL
Type and Dimensions of Project Me bL‘ '{U i ruX,r\A ( I 1 115 ' A bo4 t
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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.
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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 signature
development is exempted,will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the %
development. Official's signature
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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 1` )w...cit'`- Ii I 11 91
DEC-11-98 11 :07 API CHECKS-2-CASH 910 371 1? 57S F. 01
1
DIYIS1O? DE COASTALMANAf�Y' ENE
AIILACEn_RTEAR1AN RfPF Y O R NOTTtICA`1rIQN� 'AW''ER MILNi
_.......,_
Name Of Individual Applying For Permit: i_u f--t Ci c ca F 5
Address Of Property:
(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 itic as shown on the attached drawing the development
they are proposing. A descripton or drawing, with dimensions, should be provided with this
letter.
.._4I have no objections to this proposal.
If you have nhjrrtinnc In what is being proposed, .picaac. write the Division_siLf.,n'c"ai
Management, i27. Nortb_Cardinai Drivel 'ilmi nn, Ne h C rotina_28405 or call 9E1395_
.9f1l within lQ. s_nf rectipX itthis.notioe:.No response =s a msidere.d the same as no bi~ ikm
if y in haw.hei.n noti ed_by C'rrtificd Mai?
WAIVER 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 rnttsr initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I dot wish to waive the 15' setback requirement.
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Print Name CDENR
-/'� a No CAROLINA DICROMIENT Or
Telephone Number With Area Code EfuvicazoimCkfr AND NATURAL PritouRCFs
DEC-11-98 11 :07 FM CHECKS-2—CASH 910 371 0575 F. 01
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DWISIO?k OF COASIAI.z..t TkiSARFNEEN1T
AO.JACi:NI:ill AR1AN PROT ERTY fAYNFR NOTIF9CAIICLN1.: .I ER F'OkJ1
1
Name Of individual Applying For Pernit: _ e : ) e_ ,. c C? L
Address Of Property: —_
(Lot or Streer #, Street or Road, City & County)
l hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described to-the as shown on the attached thawing the. development
they are proposing. A descript on or drawing, with dimensions, should be provided with this
letter.
I have no objections to this proposal.
if ,yniu have nhj.rrtirms try what is.Je.ing proposed, please. .write the Oivisicn_af Cotastal
Management,.127, North Cardinal drive. Wi 1 rn i ngtajksilLEamliaa, 28405 or cal I_9E1.395.
3. l iithiu_Li3 days of_t ipl_:1f.this.notice::.No respnnse s considered.the.same as no._obitan
if...you havt.heen..notified-by Certified Mai',
,. , ,
WABiR...SRr 1i
l 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 tams initial the appropriate blank below.)
I dO wish to waive the 15' setback requirement.
I knot wish to waive the 15' setback requirement.
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Sign^ ur.e Date X(...(_5.5 ez ifn6,-,?/et_s J Lie__ ,,.,. ,1.- - -
"ni,j1/4Tame
VO— 68 ..- V/.2. ..-. NCDENR
.ACC3 Code ____— Noon`+ CAROLINA DEPARTMENT of
Telephone Number WithEF/VIRCNMlur AND NATURAI.RFSDO FR