General Permits (27)

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Applicant Name
Address
Cityr:� ►:
Project Location (Go
CERTIFICATION OF EXEMPTION e�
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 .g2Ga, —�: >"!
F
, State Road, Water Body,
Type and Dimensions of Project
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 15 NCAC 7K ,02L&r--This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
State _
Phone Number
Zip ;Q 2.7 70
This certification of exemption from requiring a CAMA permit is
valid for 90 days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
I SKETCH —_ 4Ee lV r"� (SCALE: J�-:`;a 1 ) I
Ala
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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
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development.
The applicant certifies by signing this exemption that (1) the ap-
plicant has read and will abide by the conditions of this exemp-
tion, and (2) a written statement has been obtained from adjacent
landowners certifying that they have no objections to the
proposed work.
App icant's signature
�'�/ ` " y"a
b
CAMA Official's sig. ture
Issuing date
%5 494
Expirafion date'
Attachment: 15 North Carolina Administrative Code 7K .0203

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
GARYAND WILMA DOBBINS' property located at
(name of property owner)
LOT # 119, SEAGATE SUBDIVISION, SEA GATE DRIVE
(Lot, Block, Road, etc.)
on INTRACOASTAL WATERWAY, in CARTERET COUNTY, N. C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at
that location, and, I have no objections to his proposal.
Description and/or drawing of Proposed Development
Please see attached survey by Collier Survey Company dated 1/4196 with proposed plot
plan information showing house, deck and dock as drawn by Steve Ballou Homes, Inc.
signature
LA WRENCE MIDA H
Print or Type Name
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Telephone Number

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
GARYAND WILMA DOBBINS' property located at
(name of property owner)
LOT # 119, SEAGA TE SUBDIVISION, SEA GATE DRIVE
(Lot, Block, Road, etc.)
on INTRA COASTAL WATERWAY, in CAR TERET COUNTY, N. C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at
that location, and, I have no objections to his proposal.
---------------------------------------------------------------------------------------------
Description and/or drawing of Proposed Development
Please see attached survey by Collier Survey Company dated 114196 with proposed plot
plan information showing house, deck and dock as drawn by Steve Ballou Homes, Inc.
Signature
GARY T. O'DANIEL
Print or Type Name
(�> i ri�1 - %
Telephone Number

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UR VE Y COMPANY
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Ce11�Nr DATE
Morehead City, North Car°llaa 3A)S1
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