Jessie Van Jackson, Sr

(AsitA6l aCERTIFICATION OF EXEMPTION
10 ayief
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environmental Quality and the Coastal Resources Commission in an area of
environmental concern pursuant to 15 NCAC Subchapter 7K Of(jor NCGS 113A-103(5)(b)(5)_ .
'3 e55 VA0 JALK5ON, Ti'•
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Applicant Name T t VLM T� '1 )SP'. CA C,t;? 1:_ Phone Number Cf/U 13 SCK
Address 3;a1 �i-N.44.1y L-cu► . ;
City Wi lilie t State .k)Cid Zip IMO,
Project Location(County,State Road,Water Body,etc.) 9' Frtal 'T L ii - �f irni
Type and Dimensi ns of Projec Tit- 5 dU 'Peet ell J/vfili',r/iirf/forJ,141
a Jri,e 4 / 4/14/
The proposed project to be located and constructed as This certification of exemption from requiring a CAMA permit
described above is hereby certified as exempt from the is valid for 120 days from the date of issuance.Following
CAMA permit requirements. This exemption to CAMA expiration,a re-examination of the project and project site may
permit requirements does not alleviate the necessity of be necessary to continue this certification.
your obtaining any other State, Federal,or Local
authorization.
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ra-tyy.:.:,n-A-(), SNAny person who proceeds with a development without the con- _
sent of a CAMA official under mistaken assumption that the Applicant sign ure
development is exempted,will be in violation of the CAMA if there 'l� /lis a subsequent determination that a permit was required for the A4,--L
development. CAMA Official's signature
The applicant certifies by signing this exemption that the ,//V/Sr 1)/i 3/iK
applicant will abide by the conditions of this exemption. Issuing date Expiration Date