General Permits (560)

*1 .
CERTIFICATION OF EXEMPTION 101
_Y FROM REQUIRING A CAMA PERMIT Ji
as authorized by the State of North Carolina, APR 23 !2002Department of Environment, Health, and Natural Resources and the Coastal Resources Commison
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203. CUA3TR! MANAGEMENT
M0P;;gP.'1n _ _.
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.)
Phone Number
Type and Dimensions of Project
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.
I SKETCH I, f-" 7 r \&� 1-2; N (SCALE: ) I
\ a�P
C mq
'a
Any person who proceeds with a development without the con- /K__
sent of a CAMA official under the mistaken assumption that the Al
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the —
development. C
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.
—.2
L -
nature
AMA Off icial'ssignature
Issuing,date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to vise b %� %7�J-�C_. --rp 's
(Name of Property Owner)
property located at o?y-j OLZ LuP'io�
(Lot, Block, Road, etc.)
on ic& C4EE�_, in �1401r.4,6y� fle 1- rcv/n , 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
P1114
L/
t� L;x u SK
.s
•ziN �tQzt..G� �e��K L'a�s-c
t.. Nsu »c-E:z5 rbk
'C51- 6� XM. P 25 6 L o R'zQAR�.AU
31-y0- Ts»44-1 -�29-
y
f od
4 TLC
Signature
Print or Type Name
Telephone Number
Date: 6* - % — G

ADJACENT RIPARIANPROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOAyLJ1,y/BOATHOUSE)
I hereby certify that I own property adjacent to _ 1/106HIy
(Name of Property Owner)
property lacatfdat o��S ��-� L� ��� i2J 11Y%,q %�o 4�
(Lot, Bloc Road, etc.)
on � 7-1 � ��� � � , in LAJ /JJ-; ; ;y , i � � �� ire % c ✓ C' o N.C.
(AVaterbod )
Y (Town and/or Co ty)
He hl�; described to me, as shown below, the development he is proposing at that
location, arid, I have no objections to his proposal. I understand that a pier/mooring
pis/boatlifrJboathouse must be set back a minimum distance of fifteen feet (15') from my area
or iparian . ccess unless waived by me.
I do not wish to waive the setback requirerent.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPN=:
(To be filled in by individual proposing development)
O �^
qTI
T.
M v ^
" q00 <'
t
�¢
'1
�4I y
�i
KEA A
� U�
Signature
Print or Typi Name
1 �Lt `i
Telephone Number
Date:

l / c Psi ,
CERTIFICATION OF EXEMP N T I O
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resource mission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name
Address 9 5
City \ t)hhr�
Type and Dimensions of Project
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant io 15 NGAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
Phone Number aLlq-1159
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.
I SKETCH I� F( 7 f=\0 F T/A (SCALE: l�G) I
0040,(� "_Qlm�k (b (10 7 -V tar bic,6 `n
`�err)4- r o we
��� �Y1�/y� �-GJC(LPn+ �i�-r�u✓� �iilOS
& f rr,
C YL'e1 ' —\_;>
3d
T O
N�
d n-6
t
Q_\
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.
2
App c s s
sbianature
aril 2��
Issuing date
Expiration dat
Attachment: 15 North Carolina Administrative Code 7K .02C

Ai"E?F
WCDENR
North Carolina Department of Environment and Natural
Division of Coastal Management
Michael F. Easley, Governor Donna D. Moffitt, Director
December 18, 2002
Mr. Vaughn T. Hill
245 Old Lupton Road
Whortonsville, NC 28556
Dear Mr. Hill:
Resources
William G. Ross Jr., Secretary
Attached is a Certificate of Exemption From Requiring a CAMA Permit issued to you on April
18, 2002. The exemption was mailed for signature, but was never received back in our office. In
order to validate this exemption, please sign the enclosed copy and forward back to our office in
the self addressed postage -prepaid envelope also enclosed. If the signed exemption copy is not
returned to this office and development is completed, you will have completed work without
authorization and will be subject to a Notice of Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely,
Tracey L. Wheeler
Coastal Management Representative
TLW/srk
Enclosures
151-B Hwy. 24, Hestron Plaza II, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

c Psi
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
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name vNkKcL,--, -T. �A-1�1 Phone Number agg- 1159
Address e
City State zip
Pro'e�t Location (County, State Road, Water Body, etc.) tea �� o
�I �n CJ
Type and Dimensions of Project c�-
v mnn6n, 7?i r a�
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.
I SKETCH a Fr 7 1::--7\,j �-_—J A (SCALE: l�r,r,o )
?e-frA ,�". V .— ((tee Creel" --`-�
�`✓J �m Cr-�JCiL�/t� f"t,�l'rGtn `I/lLS
G\, V er
f rr,? L
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
(� —��la"CP�ignat�ure
AMA Official'
Z
Issuing date
Expiration dat
Attachment: 1-5-No rthCarolina Administrative Code 7K .0203

A�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Donna D. Moffitt, Director William G. Ross Jr., Secretary
April 18, 2002
Mr. Vaughn T. Hill
245 Old Lupton Road
Whortonsville, NC 28556
Dear Mr. Hill:
Attached is a Certificate of Exemption From Requiring a CAMA Permit to construct a 4' x 48'
"L — head", a 4' x 30' dock, and five mooring pilings adjacent to Coffee Creek off of SR 1326 at
245 Old Lupton Road in the town of Whortonsville, Pamlico County.
In order to validate this permit, please sign all three (3) copies as indicated. Retain the yellow
copy and the attached regulation (7K .0203) for your files and return the signed blue and green
copies to us in the enclosed, self-addressed envelope.
We appreciate your early attention to this matter.
Sincerely,
Tracey Wheeler
Coastal Management Representative
TW/srk
Enclosures
151-B Hwy. 24, Hestron Plaza II, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastaimanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent toL 's
(Name of Property Owner)
LA -
property located at ©L13 L K o
(Lot, Block, Road, etc.)
on . U 4-�E E , in _._.,. �v<fow�y i f �e p�A�tcl��� 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.
�12
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Co ���
L.,
My N c 'T.5 Grbw"'s►a
v�Y�u► WAXIfAr �'� K &A>5't
hl-4. N ru atcpg K"4
V61,, 'T'' T Pt5 �4Azu
- µ ZtO.. N 2s 6 L.6 RzpAt,Xh1,1
Lj�y0. -rx*o Cawab R2�-
�fRR`c=alJ aa
"axe L. 3r h/>AP-�c�► (1 .�. I3ed'`'�
Print or Type Name
9l9- G3!--)7a -)--
Telephone, Number
Date; G - 9—
L
11t.j dll

ADJACENr REPARLAKYROPERTY OWNER STATEMENT
(FOR A PIER/MOORXNG 1'MWGSIBOATI.1 FTIBOATHO USE)
I hereby certify that I own property adjacent to V90CWN s��
(Name of Propel y Owner)
property located at
011 N.C.
— —�
()Vaterbody) (Town and/or Co ty)
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
pilinbs/boathfdboathouse myst be set back a minimum distance of fifteen feet (15') from my area
of dpan, cress unless waived by me.
1 dQ not wish to waive the setback requirement.
I d2 wish to waive that setback requirement.
DESCRI MON AND/O DRAWING OF PROPOSED DE'V�'.X OPMMENT:
(To be JUle,hn by individurd•proposing development)
'1 71 14``SL
-------------
g4tature
t
Y-� V
W /g`
Print or Typt Name
Telephone Number
Dater