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CERTIFICi T-10-N--OF EXEMPTION
FROM REQUIRING A LAMA 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 pursu;!kaU A c .t--7-K--a2L13.
Applicant Name �i�ar��✓ �a.� ois �+ssOr.
Address &oU .ram-"n��•.- .�,,i �d
City ,2itir,- /
Project Location_((:�punty, State Road, Water 1305y, ej�j T1
Phone Number 2yy-�S/9y
Zip ws7/
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-45-N 20&-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 994ays from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
SKETCH (SCALE: )
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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- hasbeerrobtained-from adjacent
landownel'S' eerfifying that -they--havena-_objections to -the
proposed•wc rk.
Applicant's signature (
L
CAMA Official's signature
Issuing date
2_3/, '2
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203