General Permits (172)

CERTIFICATION OF EXEMPTION �1 n
v1
FROM REQUIRING A CAMA PERMIT -'
�v
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources Cc ;As
n
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant jVame H C, --- /y Phone Number
Address cc / X r�
City — State Zip
Project Location ( ounty, State Road, Water Body, etc.) t 1142f -7
Type and Dimensions of Project l d c A"-y 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.
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.
SKETCH (SCALE: )
'i
Rvl1`i�-oe �J
t
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.
s signature
CAMA Official's signature v
Issuing date
74/ CZ (,/-
0
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

9
"'
I hereby certify that I own property adjacent to
Ow I iv 's property located at
(Nahie of Property Own
(Lot, Block, Road, etc.)
on �� i:C, , in /V e;6 Z&/ u, WC C &i-t, NC
(Waterbody) (Town andlor 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:
(To be filled in by individual proposing development)
112ra IA
-
S�
Sfknature
Print or Type Name
Telephone Number

yy
run+ ° cart `.
LOT 6
C \\� \ 2si� / °� \\ 67,571 sq. ft. �\ �j 55'39' try
�\
r V
52'39'52' W
—�•-- v s v 1 3G.40'
.5'12'2G* W
/ G to ALULIN PICA 83.23'
LOT 5 \\\\ \\\\. j
L \\ \ - LINE OF
56,792 sq. ft \
/ \ AREAS Oi
�OF LOT
POINT WE
P'L'TLANDS
LOT 4 \\ IN / N S Gl'40"hl' W
56,595 sq.
\\\ FILED FOR REGISTRATION
Y9,�� IS THIS
Mn \ \ \ \ PLAT CABINET
lil \ 110 All -EN MIT \ \
I ' 6 ilk ^ \\ LOT- 3
1 I £ 1 I \\ \\\ 52.230 sq. ft
\ \ R OSTER OF DEE
70'15'03' W �-
II j \\ s�\\ c,�• //. 179.21'
\ \ s
Q\ a We, utcN Mnz
LOT 2 3"
L / r\ \ 48,585 sq. ft.
sec o 5 38'44'33' W
\ J
s' \\ �'�\ I A 122.7G'
\ I
•ry'' r) y
A / \\\ \� I
\ LEGE1
0
/ • :/ IDG MIEN vr.-vc \ \ \ \
i'ry h' 4!// j LOT 1 \ \\ p S 33'45'24' W R/W = RIG
?/ r' "' r 88,737 sq. ft. \
1 109.83' � = GEC
EXTEW OF ESTUAR1Nr 1 u+
o-1 T \r,WATERS PER GHARLES Yh-'LANDS 1 IPl - IRC
_ JONE5, 8/8/g0 J
cc
1�9.82 ` = _� . // S 7031'5G' W
37_3=8. w 247.27' 105.90'
N •,•''V, C A h '•,,
\ L 42'p7 •••��
'28• W
E A L = N 22 i T L 226 o s
SECTION "A' ADDITION ` '���S Ls.\`��' h4=
N TRENT SHORES 5U13DIVISION �'�•,,�: •'R I p0\C';••'�• I
ZONE R-15
'� `�TEARDS POIA

I hereby certify that I own property adjacent to
N 's property located at
(Na&e of Property Own
W 14 R'k f o , a
(Lot, Block, Road, etc.)
on � R � i2� � is[. , in Ce?&n_., NC
(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:
(To be filled in by individual proposing development)
f 1�t'i0 JFZ� • �i`d cc�
P�-
10-
JAo
�,/ Signa
Print or Type Name
Telephone Number

LOT 6
IIC, \D ?sse l °ry \\\ 67,571 sq. \
p1 �—
to Auo+ Devt \\ \\
LOT 5 vv v:v
56,792 sq. ft \ \
JN ,
LOT 4
56,595 sq. ft.
I \ \ N
j S',
to
1 \
\ \
o uirx van
52,230 sq. ft.\ \\
5 70'15'0,
I,� fir•, 1 b�j I \ \ \ Q /
sc,• !� 179.21'
Q\ \ \ a We uir)4 MIVE \ \ I6 3
c��_ u / \ LOT 2
;/ %�•\ \ 48,585 sq. ft
Lp/
/ \ \ \sec j 5 3B'44'33' W
LIP
\ >> \ to
122.7G'
LOT 1 \\ N 5 33'45'24' W
88,737 sq. ft. \1 lOq.83'
r�\+ EXTENT OF E5TUARIKE 1 CF
µl T WATERS PER GHA.RLE5 Y,671-4NDS 1 p
2J _ JONES. 8/8/90 )
a
119,82. sn"o so' / 5 7G'31'5G' W
Lj )U J/ Yv
G2'
5 )5'3q' W
,,.BG'
2*3q'52' `ti'
3G.40'
5 5'12'2G' W
83.23'
LINE OF I
AREAS Of
OF LOT
POINT `i"L
I
Q'40'41' W
227.3q'— —
FILED FOR
iREGISTRATION
THISC/��i
• PLAT CABINET
R ISTER OF DE
4
/4
LEGEr
R/W
= PIG
= GEf
IPP
= IPC
GP
= GC
L•-7` , N 3W = -} 105.g073358 247.27
• •iEA
h
Li
0 0 22 e ? T L•2264 o
5EGTION "A' ADDITION �pF sU k4•.
'•
N TRENT 5HORE5 5UBDIvI5ION "'•.1.,•'R .....o\"�""'
ZONE R-15

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