General Permits (251)

CERTIFICATION OF EXEMPT
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0
Applicant Name — �/Ott.✓ /YoRK11,J,)wi,7-fi
Address ?0! y ' �► .... ,,,r
City or,s'_" iu 1
Project Location (County, State Road, Water Body, etc.)
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State
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sources Commission (�
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Phone Number 419- 2r1'1-aS7
Zip 2fsS -2,/
Type and Dimensions of Project ;k ,fie 2 ju' he 4 r lhg� l tr / e%a �Y'ids' ' 'A k �G�
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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- valjd f6r 90 days from the date of issuance. Following expiration,
quirement pursuant to 15 NCAC 7K .0203. This exemption to a red 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.
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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.
pt t e u
u
LAMA (-miclal's signature
/924
Issuing date
17 ,/_ - s /CAI_
Exprration date
Attachment: 15 North Carolina Administrative Code 7K .0203

State of North Carolina
Department of Environm. ent,
Health and Natural Resources • a
Division of Coastal Management
James B. Hunt, Jr., Governor ID E H VA F�
Jonathan B. Howes, Secretary
Roger N. Schecter, Director
January 18, 1996
Mr. Larry Arnold
Post Office Box 2277
Morehead City, NC 28557
Dear Larry:
Attached is the Certificate of Exemption for Mr. John M. Smith at Buccaneer Bay on
Smith Creek to add one mooring piling, relocate two other mooring pilings, construct an 8' X
18' platform, and to add a catwalk that measures 1' X 18' and 2' X 11' .
In order to validate this permit, please sign all three (3) copies as indicated. Retain the
original for your files and return the signed carbon copies to us in the enclosed, self-addressed
envelope.
Your early attention to this matter would be appreciated.
Sincerely,
M. Ted Tyndall
Field Representative
MTT/dh
Enclosures
P.O. Box 769, 3441 Arendell St., Morehead City, North Carolina 28557 Courier #11-12-09
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

POBOX 776 -PAMLICO COUNTY }.BUILDING INSPECTIONS
[phone]
BAYBORO, N.C. 28515
(After this form is completed by the landowner proposing the project,
a cgpy is.given to hislher adjacent landowners for their consent an
signatures. The forms are then returned, along with a building pl
and other applicable required information, to the Building Inspections'
Office for building permit application/processing.)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT EPN#
I hereby certify that I own property adjacent -to
N✓%TfV rr Y----
Name of landowner proposing development body of water
in/near GRI6IyTAI- Lot#ZV of 1314 CCAA16 2 6AY
community, Subdivision, if applicab e
Tax Parcel # ,2 2 1 off SR Complete description of how to
locate this property: ZGAl4<,8LAeK6eA- 12D Q<1VL; //f 13UCc,4,VCEY2 6A�
,56i8l�Jv1SJOM OFF fedCHCS COVE RD NEAR kE25/,-4A) A'D o flWy_SS;
The proposed project, a DOCK AafiDLAP A-LT6QRantd"Jthe location has been
described to me as shown in the drawing below and I have no objections
to the proposal.
FOR A PIER, CHECK ONE OF THE FOLLOWING:
I wish to waive the 15' minimum setback from -my riparian access.
I DO NOT wish to waive the 15' minimum setback requirement.
Draw the proposed structure in the space provided below. Lut the site
of the structure and measured distances from the adjacent property
lines, other structures on the property, and the road, water, etc.
T-�-
6 r ,B uI&D 19� t�o�k CXTciVSIDnJ oil
OF EX16 R NCB P161Z I V 17-4 < 67-W, 46 K A -Co 0,vD
&50 /020/z�,SE MOVIN,--
Z T E hm,5S r25eT ,, 7tic EIV Tlke' F'oi— EC i
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Printed Nary 4-Vj ll ,%��/��/`'��'� —pate_
_' Signature

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POBOX 776 -PAMLICO COUNTY BUILDING INSPECTIONS BAYBORO, N.C. 28515
[phone]
i
(After this form is completed by the landowner proposing the project,
a copy is given to his/her adjacent landowners for their consent and.
signatures. The forms are then returned, along with a building plah
and other applicable required information, to the Building Inspections'
Office for building permit application/processing.)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT EPN#
I hereby certify that I own property adjacent to
-,brtN MD,2&AAI sue► r l ij -Is on
Name of landowner proposing development
-SmIrH CP..EEX
body of water
in/near Lot# of 13NCCA"ic- 2 13AY
community, Subdivision, if applicab e
Tax Parcel Z 2 off SR Complete description of how to
locate this property: DAIVG-= / f J CG4NEEY'i 18,4+
,5ti8 J1v/SrDN OFF r6&cHE5 Co VC I�D VEAQ kEfOff)q k/ RO OFF Hwy sS
The proposed project, a L10CK AafpSLlP Prt .9 and the location has been
described to me as shown in the drawing below and I have no objections
to the proposal.
FOR A PIER, CHECi -ONE OF THE FOLLOWING:
I wish to waive the 15, minimum setback from -my riparian access.
DO NOT wish to waive the 15, minimum setback requirement.
Draw the proposed structure in the space provided below. List the size
of the structure and measured distances from the adjacent property
lines, other structures on the property, and the road, water, etc.
-- -- _ EE 4 77r.4C#EP ,5h1c 6 7— --
�(�uJr'o�JG T 8Ui 'F,xJq Dock �XTceVS/Dt\) OnJ
1Nsr0� DF EX167-1,V6 P16/Z IVI7i ;,67-1-V,4&K 4)&0'VD
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Printed Name_ A NJCS t' M Il.L�7 Date 2 2'j �qSignature '�G

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DRIENrAL N. i', 28571
919 249 Oh52
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