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CERTIFJGATIteC �% EXEMPTION
A
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 NOASISnbcfTepter-7W:02LG
Applicant Name A, (tf 5;,1=
Address --a
City e•,
Project Location (County, State Road, Water Body, etc.)
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Type and Dimensions of Project
State
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c of
Phone Number f-J� - 26, 7
_ Zip .` &_'S6 S
The proposed project to be located and constructed as described This ccrt'ification of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit re- valid for.96>;d,ays from the date of issuance. Following expiration,
quirement pursuant •ta 1'5•-NG4C--7K--@2E8. 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.
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I SKETCH (SCALE:
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l.(J/� �7 I 71F0 /'1 A' r y
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 state mentbas-been obtained ftornadjacent
landowners certifying that they- --have - no objections .to -the:,
p roposed.wotk.
App icant's ftnature
CAMA Official's signature
ed-z Y-
Issuing date
'7 -. 3,
i
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203
f
State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Coastal Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Roger N. Schecter, Director
NX 2_40'nW
Dear Ci
EDEHNR
DATE: ��- 2 Y , 1996
`` OaS
b� r
r
j Attached is a Certificate of Exemption From Requiring a CAMA Perms In order to
validate this permit, please sign all three (3) copies as indicated. Retain the yellow copy for
your files and return the blue and green signed copies to us in the enclosed, self-addressed
envelope.
Your early attention to this matter would be appreciated.
Sincerely,
Field Representative
/dh
Enclosures
AW
RO. Box 769, 3441 Arendell St., Morehead City NC 28557 Nio
6 An Equal Opportunity / Affirmative Action Employer
Voice 919-726-7021 FAX 919-247-3330 Courler 11-12-09 50% recycled / 10% post -consumer paper