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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
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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 c9.pcern pi uant to 15 NCAC Subchapter 7K .0203.
icant Name U ✓ f Phone Number ` > _./ if S 1
iv17 r=n stct�
ess � ! 1 -v.
!mt. WI State Zip' Fib
.ct Location Co nty, State Road, Water Body, etc.)
S-C-' 0 U LA L.D C°4 T lQ I /fir .• IIPT.
TO { r✓T(MM- (rv- .
and Dimensions of Project r?_1/a K C'1 d --a- 404k ri •
)roposed project to be located and constructed as described This certification of exemption from requiring a CAMA pei
e is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expir
ment pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be nece
A permit requirements does not alleviate the necessity of to continue this certification.
obtaining any other State, Federal,or Local authorization.
ETCH (SCALE:
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INCMPORT _ N T
E.Y Y . G O DW I N'V SONS I N C■ Claims for error or shortage must be made in 3 days.
A restocking fee of 5%is made for materials returned.
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car age fee of i C46 is made for picking up materials.
DEALERS IN BUILDERS SUPPLIESt•;,,:e4,1^os made on special rnaoe mate
P.O. BOX 1806 • WILMINGTON, N.C. 28402 Ne retunos allowed on material not in same condition as
No refund or credit without original invoice or invoice nur
[phone] • FAX [phone] No refund on materials after 60 days.
SOLD TO SHIP TO
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