General Permits (3871)

5 _F EXEMPTION
Applicant Name , _40s.n.rr 'G , iIr; 41,— :,,r.,f Phone Number
Address 7
City 4, /
Project Location (Cou
s of Pro
o be located and constructed as described This cer
-�1
aeh1�11�C
�h�-r0203. This exemption to a re-examination of the project and project site may be necessary
ments does not alleviate the necessity of to continue this certification.
er State, Federal, or Local authorization.
(SCALE:
/f�,, )
eds with a development without the
urination that a permit was required for the
by signing this exemption that (1) the ap-
ill abide by the conditions of this exemp-
statemertt{ISasbeei obtained
irom adjacent-.
:-ihat-,
na:
objections --.to -the
r,
i, State Road, Water Body, etc.)
Type and Dimension
4
&
,
State Zip � S3�
ii:ication'of exemption from requiring a LAMA permit is
ed as exempt from the CAMA permit re- - valid for�'zf�ays from the date of issuance. Following expiration,
quirement pursaant.to
I
The proposed project t
above is hereby certifi
CAMA permit require
your obtaining any oth
� SKETCH �33-920,
Cr
con -
under the
exempte
d,
1:,�= /�� �;• .�.�- .,,�cEf c��+ mil;►'<r � �� � �?7_, .:,�('r� r(j�. '�rpr�, ; �'
r!'i r � !Y (. �.,'� SC�JrI-*' ����!'>-ram E j� 07• � l%J d�`' G'r�' �-•'" ,f�M'�
mistaken assumption that the
development is
will be in violation of the CAMA if there
is a subsequent deter
-
they.,:-have-they.,:-have-
-
Any person who proce
sent of a CAMA official
development.
The applicant certifies
plicant has read and w
lion, and(�)•a•written�
landewners ,,certifying
proposed. HJac{r
i5 cant's sigrfa�ire 4
LAMA Official's sign lure fill ralfA
Issuing date
NOV
o 8 19%
.ai-
Expiration date ,, �►
Attachment: 15 North Carolina AdministrativM66t3-?K-V@@*

State of North Carolina
�CX-partment of Environment,
Health and Natural Resources
Division of Coastal Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Roger N. Schecter, Director
7/- . AyC --NS-3 9
Dear W
1DEHNR
DATE:r/. 1996
Attached is a Certificate of Exemption From Requiring a CAMA Permit. 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
P.O. Box 769, 3441 Arendell St., Morehead City NC 28557 NiE4 WC An Equal Opportunity / Affirmative Action Employer
Voice 919-726-7021 FAX [phone] Courier 11-12-09 50% recycled / 100% post -consumer paper