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- TIFIG Tl 1MG17 EXEMPTION
No 2TMA
iffil AMA 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 r C4 Cit A6 M Phone Number 2611 - YJQ/U
Address 1-s/
CityC State M Zip �
Project Location (County, 8t to Road, Water Body, etc.) �l
f 1 C ffd 4, OiC n/
Type and Dimensions of Project 6teI r " & Ar
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 1.5..NGAG=.71<,0203:. This
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This ccrtification of exemption.Umn requiring asCAMA 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.
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Any person who proceeds with a development without the con- J
sent of a CAMA official under the mistaken assumption that the Applicant's,$)UH.Y.J.
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
CAMA Official's signature
development.
08 , /0 '00
Issuing date
The applicant certifies by signing this ex9axpWathat (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.
49r
Expiration date
Attachment: 15 North Carolina Administrative Code FAftlAW