General Permits (94)

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 l/
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
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Applicant Name o.-/.; t /.�� /;f Phone Number '�19- 741.0 VI 7.f
Address %or 127
City State NG zip ly. S'f 7
Project Location (County, State Road, Water Body, etc.) "22,.,?
Type and Dimensions of Project, %rr ���� �G �.. �i1� �;r�; �•„ <x,�!,.,, �nr r
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.
.f
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.
j SKETCH (SCALE: •,4/) j
----iZfss.�,''
all
f' jof
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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4
Applicant's signature_
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

I hereby certify that I own property adjacent to GnttlCk,� -t TAIVA5 NOM?,,
(Name of Property Owner)
property located at SoU- t � \ k k sT- I
(Lot: Block, Road, etc.)
on \v , in Y �\QQt&1(Eat , tWatextody) (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 DEVELOP'M[EW
(To be,filled in by ia&vidual proposing development)
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M
Off g - 417Z -V10
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9.10
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Signature
Print or Type Name
C `� ,-
;jitephoni Number
» GV04d Date: / t� / 9
erc numumut-MA 1.1-VT i.rw a C? �Ci01 Cr,Ft—�L—nOta

NOV-15-1995 0B -HUM UUM MUKtHtHV 71y d4'( SJ3kJ 1U e,c
This letter is to notify you as an adjacent riparian landowner of MWMrs
W C�'n (�_'�, plans to construct A tay5tiota of 1-m � 2 P \ %9
on their property located at (a -50 wn�
in Y t J Di- MYIZr , NC. The sketch on the reverse ride accurately depicts the
proposed construction.
Should you have no objections to this proposal, please check the statement below, sign
and date the blanks below the statement, and return this letter to:
Nc>oy Pb la"? ��00EA 1���- UAr�Qc�EJ�g.,,}$
as soon as possible.
Should you have objections to this proposal, please send your written comments to the
N.C. Division of Coastal Management, P. 4. Box 769, Morehead City, NC, 28557. Written
comments must be received within ten (191 da-vl of recgipt of this notice.
Failure to respond in either method within ten UQ) days will be interpreted as no
objection.
Sincerely,
x ixve no objection W th prcjet t as presently proposed and hereby waive the
right of objection as provided in General Statute 113-229.
I have objections to the project as presently proposed and have. enclosed
comments.
Signature
DATE:
TOTAL P.02

40

Hoover
P.O. Box 127
Vandernere, N.C. 28587
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$2

SENDER:
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N • Complete items 3, and 4a & b.
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Mreturn this card to you.
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does not permit.
I also wish to receive the
following services (for an extra
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3. Article Addressed to: 4a. Article Number
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4b. Service Type
❑ Registered ❑ Insured
❑ Certified ❑ COD
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K�ic� � cca U I � iv C
El Express Mail ❑ Return Receipt for
Merchandise
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7. Date of Delivery
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5.
Signature (Addressee)
8. Addressee's Address (Only if requested c
and fee is paid)
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Signature (Agent)
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>, PS Form 3811, December 1991 *U.S.GPO: 1993-352-714 DOMESTIC RETURN RECEIPT
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