General Permits (525)

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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT as authorized by the State of North Carolina, 1 K-0 3030819A
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 Name leo v" F)t• All c; 7 x Phone Number
Address r-i ` 8ck 2 3
City t.,: State C Zip 2 P _TZ Y
Project Location (County, State Road, Water Body, etc.) (A. l v �^ a t , t 7 ,
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Type and Dimensions of Project .�t'� �� , r. c �+ 47 .
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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.
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.
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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.
Applicant's signature
C r c�I
CAMA O idial's signature
I -i� C%Z
Issuing date
�' - &-OZ
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

'_AAR- 6-02 WED 5:17 FM FIANNING&INSFECTIONS FAX NO. 2527286643 F.
CARTERET COUNTY PLANNING & INSPECTIONS
[phone]
C—qRT'
ERE7'CO ULN'?`lf.
_ P q�Vj XG & PERAUTS
DEPAR II kf EA7
Administration Building
Courthouse Square
Beaufort, NC 28516
Fax Number: (919) 72.8�6643
[phone] Planning
/ Ss19 728-85�5 Central Permits
DATE: ,3/d.�C � �
TIME:
TELECOPY TO:
NAME:
LOCATIONIOFFICE
FROM:
NAME: )—/Wx
NUMBER CF PAGES (INCLUOING THIS PAGE): L(
MESSAGE:
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MAP,- 6-02 WED 5:17 PM PLANNING&INSPECTIONS FAX NO, 2527286643
F. 2
CAMA PROJECT TRACKING SHEET
Applicant's Name: Z,
Sol
Exemption: Q Permit: Q Number:
Application to be returned for the following reasons:
Date Returned: 0 � /D
Application considered accurate and complete for processing? Date: _
The following site -specific observations have been made:
1-1 The following conditions to be included on the permit (in addition to standard conditions):
LPO:"
Dates of follow-up visits:
Final inspection Date. -
Project determined to be in compliance with permit
Project determined to be out of compliance with permit
Action taken to bring project into compliance with CAMA: —
LPO:
Date:

JAR- 6-02 WED 5:17 PM PLANNING&INSPECTIONS FAX NO. 2527286643
t1Lrly1Gbbb ZJ:j'L 15'L45iUU15 L EDWARD5
ADJACENT RMAR AN PROPERTY OWNER STATENENI T
(FOR A PIERIMOOR'ING PILINGSIBOATUMBOATHOUSI7
I hereby certify that I own property adjacent to _ �CEy��t/ Z7� T2 's
(dame of Property Owner)
property located at N '
(Lot, Block, Road, etc,)
On ._ C/a t _ - --> in Vvls , N.C.
(Waterbody) (Town and/or County)
Ha has described to me, as shown below, the development he is proposir.- at that location,
and, I have nv objections to his proposal. I understand that a pier/mooring
piJ ngs/bmdift/boathouw must be se; back a minimum distance of fifteen feet (15') From my arcs
of riparian access unless waived by me.
I do not wish to wa;r-e the setback requirement.
I da wish to waive ti-at setback requirement.
DESCRrMON AYD/OR DRAWM OF PROPOSED DEVELOPMINT:
(To be filled in by individual proposing development)
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nature
Tohn e-. hN-14'2-4t7
Print or Type dame
Telephone Numbtr
Dare: --� - a -? - :)- ,
F. 3
FAGS 01

4AR- 6-02 WED 5:18 PM PLANNING&INSPECTIONS FAX NO. 2527286643
F. 4
ADJACENT RIPARIAN PROPERTY OWNER STATEMEINU
(FOR A PIER/MOORING PII INGS/BOATLIF (BOATHOUSE)
I hereby certify that I own property adjacent to eF�;i,D�PIF �Ia T* 's
(Name of Property Owner)
property Iocated at ifs T9dI)ZE D au dy
(Lot, Block, Road, etc.)
on YvA 7 in 1dl6 , N.C.
(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. I understand that a pier/mooring
pilinss/boadift/boathouse must be se: back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I �,Q wish to waive t; at setback requirement.
DESCRIPTION ANDIOR DRAWNG OF PROPOSED DEVELOP`tENT:
(To be filled in by individual proposing development)
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or
►gnature
Print or Type Na6e
-;ZAram-
Telephone Number
Dace:

U41iJ1Labb 1j:31 15245188i5 L EDWAUDS PAGE 01
ADJACENT RII'ARL-%N PROPERTY OWNER ST'ATENMIN '
(FOR A PIERIMOORING PILINGS/BOATLIF77BOATHOUSE)
I hereby certify that I own property adjacent to KIF—VIAL D DJL*r_7' ,s
(Name of Property Owner)
property located at I[V 376?ZENp uu0'I Q.
(Lot, Block, Road, etc.)
on CAU4 , in -DAtlis , N.C.
(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. I understand that a pier/mooring
pUingvboadiftlboathouse must be se- back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I dQ wish to waive tI at setback rec uirement.
DESCPUMON AW/OR DRAWr G OF PROPOSED DEVELOPtiM-.N`I:
(To be filled in by individual proposing development)
TO CORE- WUND __
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,may
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----------------------------------------------------------___
nature
Print or Type Name
Telephone Number
Date: __' -,2 -? — -2,

ADJACENT RIPAR AI PROPERTY OWNER STATE. LEI
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 41 A; 's
(Name of Property Owner)
property located at N <,� i_M.,b' AJJ Rp
(Lot. Block, Road, etc_)
on ' xX in QAd/ 6 N. C _
(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. I understand that a pier/mooring
pdin as/boatlift/boathouse must be se: back a minimum distance of fifteen fetit (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I Q wish to waive t .at setback recuirement.
DESCRIPTION AiND/OR DRAWr G OF PROPOSED DEVELOPNfE`-T:
(To be filled in by individual proposing development)
Cuff. S Iu0 --
Signature %
A
Print or Type N,afhe
7
Telephone Number
Date:

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