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CERTIFICATION OF EXEMPTION
Y- 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 NCAC Subchapter 7K .0203.
giant Name
�/v1 p r �� Phone Number
;ss 6
-t CC State Zip
ct Location�County, State Road, Water Body, etc.)
to Gtt C-e'
and Dimensions of Project
)roposed project to be located and constructed as described
a is hereby certified as exempt from the CAMA permit re-
ment pursuant to 15 NCAC 7K .0203 This exemption to
A permit requirements does not alleviaOthe necessity of
obtaining any other State, Federal, or Local authorization.
=TCH
This certification of exemption from requiring a CAMA per
valid for 90 days from the date of issuance. Following expir
a re-examination of the project and project site may be nece
to continue this certification.
(SGALt:

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