Gillard

• 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 3ç' e'rre5c , 1°v-rci Phone Number
Address !i 11 (p Ee-- e--{-
City 7, . 1 n c , l', k1 State _ '� zip 23 2_
Project Location (County, State Road, Water Body, etc.)
*ho f e s Ari tie., . n s Fr.fr I ce V....V....Type and Dimensions of Project ,U ``.ul k n
CI , P1rpcog mime_ ,.,1 do'
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: No- )
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Any person who proceeds with a development without the con- JOIN MarvA
official under the mistaken assumption that the A icant's si nat e
sent of a CAMA p p� g ,—
development is exempted,will be in violation of the CAMA if there i .�y�1
is a subsequent determination that a permit was required for the , Crv-,0 1 ' t
development. CA Official's signature
The applicant certifies by signing this exemption that (1)the ap- 4L- ,u f 1 q&
plicant has read and will abide by the conditions of this exemp—
tion,and(2)a written statement has been obtained from adjacent _ J I 0 f \9q 8

,y i•._. 1L •.J J r. ui U1
itiER (�
NOTI CA'Y'I N WAIVER k' gM
% .r
/ ''�X Of Individual Applying For Permit d ,
Address Of Property: S.- ------_
?t ;= vL Pi1,iJ
' 1/6 w
{Lot o Street #, Street oar Road, City & Co
unty}
'• W_ '• hereby certify that I own
rafsrane d property. Property adjacent to the above described to me as shown on he ual attached lYing for this
deey are 1?ropcsin
permit has
should be provided with thisrletter.tion or drawing,
the dime lions,
y, with dimensions,
.e I have no objections to this
Proposal .
w i in
1 a ea w its ;he
40 or ca ' n , ive Etens
c No n d 95 00 w' r, rl o s c liter the me
.......... v he oti ' b erti
eci Nei
••
9? It SE _h*Tnwr
understand that a pier, dock, mooring
house, lift or sandbags must be set back a minimum distance
Pi�•ings. breakwater, boat
tofrom my area of r_parian access unless waived byf of is `
be waive the setback, you mus _ initial the appropriatems
below. ) wish
blank
I do wish to waive the 15' setback require
Imeat .
, , wish to waive the 15' setback requirement .
• ' ZrZt'---- 4i/Xr
Pr ratEerw _
gimir
t A ea Code Onslaw County
Onslow County Planning Department
604 Co114ge Stzeet
• Jaak5onville, NC 2.5540

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit :
Address Of Property: S 1 S L1�4,/,.
k 5X,,s /9,'. S.,vp.als
(Lot or Street #, Street or Road, City & County)
•
I hereby certify that I own property adjacent to the above-
referencd 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 drawin
should be provided with this letter, g, with dimensions ,
kti )S I have no objections to this proposal .
If you have objections to what is being proposed, please write the
Division of Coastal Management , 127 Cardinal Drive Extension,
Wilmington, 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 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 ap
propriate ppropriate blank
k)'"-Q
,Y I do wish to waive the 15' setback requirement .
I do not wish to waive the 15' setback requirement .
�"c/ 9 8� g ; lakt >4.
Signature Date
Print Name i '
9l0 3s 7- 332. a Onslow County
Telephone Number With Area Code
Onslow County Planning Department
604 College Street
.IhAltvnnville Mt, QOGAA