General Permits (51)

CERTIFICATION OF EXEMPTION
Y- FROM REQUIRING A CAMA PERMIT _ (4
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as auth°'brized 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 Rame 5A-e-; e3 / I EV t
Address ro /30,4 V 3 (10
City E -yr a-, 0 1 ./ I s I,s
Project Location (County, State Road, Water Bc
4 C,/) Cr, �-,-) -(; f .
etc.) C nay
State
Phone Number 7 / 9 - 34' /- 91 aP
Type and Dimensions of Project t t c,c n 1 I d 3
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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 .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
5^
This certification of exemption from requiring a LAMA 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.
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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.
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CAMA Official's signature (/
Issuing date
� .- ? ,: 4
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

MEMO
TO
DATE:
SUBJECT:
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From:
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North Carolina Department of Environment,
D
•�///O Health, and Natural Resources �� printed on Recycled Paper

CARTERET COUNTY COURTHOUSE
CENTRAL PERMIT OFFICE OF
COURTHOUSE SQUARE
BEAUFORT. N. C. 285 1 6- 1 898
728-8545
BUILDINGS. MOBILE HOMES. ELECTRICAL. PLUMBING. MECHANICAL
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
i thereby certify that�I own property adjacent to:
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property located at: &00 of phi;-'
near ( water body) �Zoj . cs-evrJ
in ( county) A P
The applicant described to me as shown below, the development
he/she is proposing in that location and:
no objections to this proposal -
I have � P P 1� PrnmAly
�"�l.l,:l-tl- 4 .°
t this proposal I do have objections o p p
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Description and/or drawing of proposed development:
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� Signature:
Name :
Phone Number: `71 - — �7

CARTERET COUNTY COURTHOUSE
CENTRAL PERMIT OFFICE OF
COURTHOUSE SQUARE
BEAUFORT. N. C. 2851 6-1 898
728-8545
BUILDINGS, MOBILE HOMES. ELECTRICAL. PLUMBING, MECHANICAL
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
i hereby certify that I own property adjacent to:
E
property located at: 00 �oCZAiO l�
near (water body)og�� �oYrd
in ( county) CA P --F'Q1—
vbDJvis� o
The applicant described to me as shown below, the development
he/she is proposing in that location and:
I have no objections to this proposal
I do have objections to this proposal
Description and/or drawing of proposed development:
Signature: /iPLlS
Name: 14)(011I In.
Phone Number: �`� r 44

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