General Permits (292)

Applicant
Address_
City
Project b
CERTIFICATION OF EXEMPTION
Of
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 to 15 NCAC Subchapter 7K .0203.
Z
'.E'f',;i' C.'�q Phone umber
County, State
Type and Dimensions of Project
State 4LI. t Zip
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- valid for 90 days from the date of issuance. Following expiration,
quirement pursuant to 15 NCAC 7K .0203. This exemption to a re-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.
SKETCH a 5 (SCALE: )
r
Any person who proceeds with a development without the con- / \
sent of a CAMA official under the mistaken assumption that the Applicant's signature
development is exempted, will be in violation of the CAMA if there _>�71 /�
is a subsequent determination that a permit was required for the �'����
LAMA Official's snafure
Ovelopment.
The applicant certifies by signing this exemption that (1) the ap- Issuing date
plicant has read and will abide by the conditions of this exemp-
tion, and (2) a written statement has been obtained from adjacent f,�.
landowners certifying that they have no objections to the Expiration date
proposed work.
Attachment: 15 North Carolina Administrative Code 7K .0203

05/14r93 11:44
s b s
Y
V919 4i 47 0687
I
GI
CONST.
W O01
COMP
2
May 14, 1993
IS J BAL GH CFP
IVE .F CXAL SERVICES
0 West/ PC Box. 8.8 Havelock, NC 28532
FADS 1M t L,E
ro: Jim Mercer
Company: Cama
Fax #: 919-247-h330
TT,A,L
No of PayeB-4 !(including transm.it�al sheet)
Sender: Louis J �alogh and Carol Balogh
McBeage: Cama Exemption Lot 26 Cherr Eran.ch Havelock, NC
�I
Since ryl f
Louis J Balogh CFP
919/447-8054
Fax Number 919/447-0687
I
Securities Offered
Through
Compreh
naive Financial 6ervicea
Branch offict .075
WailluL 5L
.Suite 324
Fary NC 275JI Y1Y14M1-22'o6

05/ 14/93 11. 45 12919 447 0687 C I ESMO CQNST. W 002
RI
j I hereby ceftify that I own
L_ a Gd f s C6
(4am of Prdpexty owner)
- (.
tty adjacent to
_,__'s property located at
lot qJ0 I J'. C'
{Lot, Block, 1 a, etc_)
ones
(waterbody) , in--�ac.. , N.C.
TOwn and/or County)
He has described 910 me, as shown, bel w, the development he is
.-_-- -- Proposing at that, location, and, I h ve no objections to -his -
proposal.
DESCRIPTI AND/OR DRAWING ©r PROPOSED DEVELOPMENT: C) �Ld
(To be fil]kd is by individual proposing development)Dl J 15'Wit "
TO
(�- -zoo, 0
Fuse
C't
RI V Fit
-_- I..i
nt or
e
- 5),

05/14/93 11:45 V919 4 1 47 0687 C1
AN
T hereby certify that I own pj
41 S 1* 0 AP-0 I— 6A t-C)6 ti,
(Raine �ofPtoperty Owner)
(Lot, Block, I
(W.—At—er-b—od-yinJ
He has described to me, as Shown be
proposing at that location, and, I
proposal.
CONST. 14003
rf OWMM STATEMMU
iperty adjacent to
is property located at
LoK-q.
,ad, etc.) 11
9& LM4 or- (C- Nc- N.C.
(Town and/or county)
ow, the development he is
Ave no objections to his
(TO bi;—f Jilled
Lal NrOPosinq development)
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�i_c nature
P�int or io Name

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