General Permits (565)

-ter- CERTIFICATION OF EXEMPTION } ��� ;
FROM REQUIRING A CAMA PERMIT mo�fa /SA
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 6nL Mtn I jPhone Number
Address :4, a� tic 1 C' Inc t ;
City State
Project Location (County, State Road, Water Body, etc.)
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 go 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 (SCALE: )
your project is subject to the North Carolina Division
of Water Quality Neuse River Buffer Rules due to its
location within the Neuse River Basin.
Please contact Deborah Sawyer or Tom Steffens
by phone [phone] or via e-mail
Deborah±$[e-mail] or
[e-mail]
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C77t,�,, �r��K.'•i �G � e"e�; �G� u� 5u � fC' qL Sty So c�S r:0
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.
I , J
Applicant's signature
CAMA Official's signature
//2 t rh n�f71�1-
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

,03/20/02 08;19 FAX O1
TO- Tracey Wheeler (Cama)
Fax#: [phone]
Date: March 20, 2002
Page#: 3
From: Foley & Foley (Sandy)
Phone#: [phone]
Customer Work Sheet
Customer Name: Bob Hollebeck Date: March 20, 2002
Mailing Address: 2602 Old Cherry Pt, Rd -
Job Address: Same Phone: [phone]
Ad
jacent Properly Owners
Left Side: John Jones Right Side: Larry Ames
Job Type Description
Bulkhead Extend existing bulkhead 25'ft
Dock/Walkway
Platform end of dock
Boathouse
Boatlift/jet ski.
Piling
Ramp/Jetty
Dredge
Rip Rap

03/20/02 08:19 FAX
Z02
ADJACENT RIPARIAN PROPERTY OWNERS STATEMENT
I hereby certify that I own property adjacent to l�o�r4 ra c lc s
(Nurse of Prnptm own-s))� /�
property located at oll,61- G1 Q cAa �. +�-- •+"1 � >
on lJ u 12 �.�-z in N t,� Q fj � "A C�Ok►W_C.
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
1 (To be filled in by individual proposing development)
0�-
Nw1 A
Siena
le
Print or Type Name
Telephone Number
Date
Foley & Foley Contractors

03/20/02 08:19 FAX
M
ADJACENT RIPARIAN PROPERTY OVVNER STATPMENT
I hereby certify that I own property adjacent toy�n�CChtsG << 's
(Name or Property Owner)
property located at &6 .2 MLA r A e Q,"
(Lot, Block, Road, etc.)
on ti' fa 6� , in _ AV 1;:J B � �`� � N.C.
Materbody) (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 by4ndividual proposing development)
"V,A
pj--
�1.
AJua
h
gn re
Print or Type Name
Telephone Number
Date:
koI-