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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT 9P$ 4- /c?7/SC
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 47,4. A� / 9, A1/2 //JE. Phone Number gL• d4.7s
Address /4 / 1e4 ,1, ./ '��lr/z
City l yI'Mis„'.,fftbi, Slate /PC- Zip 7s y//
Project Location(CoLJnty, State Road, Water Body, etc.)
1/9 . o h Saa1.l, P a SS" �,r «+�7� y75 dfrws,
Type and Di ensions of P oject EX t',S1 �D � *7 j,-„ r -, ' Zr«/ 4i>-S44.0i
/i, I/MI7_ a /G 9 /.�,f, r ,0, 1.51�"ee , 0019,e7 �.�, c-"�4// , ii/ /7
The proposed project to be located and constructed as described This certification of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expiration,
quirement pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be necessary
CAMA permit requirements does not alleviate the necessity of to continue this certification.
your obtaining any other State, Federal, or Local authorization.
SKETCH /✓- L#09 Aprfr�} I !'Gii��i 6‘
e4<erel,7,1k#5 . (SCALE: A/75
�i✓D/''+C Ors 4r ,,Dyif, /el a,e7e-,- fer
P/ `4(45' k ,G/a3
(iry p i/74'
Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assumption that the A i ant's at�
development is exempted,will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the 2
development. CAMA Official's signature
/a-2 9 -0y
The applicant certifies by signing this exemption that (1) the ap- Issuing date
plicant has read and will abide by the conditions of this exemp-
tion,and(2)a written statement has been obtained from adjacent //—29
landowners certifying that they have no objections to the Expiration date
proposed work.
Attachment: 15 North Carolina Administrative Code 7K.0203

U.S. ARMY �� ! ' i � ERS
WIL GTON D '' `
NOV082004
Action Id. bC.s obtoy DIVISION n County New #4ivove,t
QSTar MANA �
GENERAL PERMIT (REGIONAL AND NATIuNwIDE) VERIFICATION
Property owner m r . Ph { l i‘ ,I . !Q
Address / 7? , ' /)
�C Cn✓
Telephone No. C 91b) 6“,
Size and Location of project(water body,road name/number, town, etc.) �'re- I bra.,W a
s
tvs-t ----,5(4.1p-t-r)•
Description of Activity PE?r`C;.rw(. earl. ik l l c 1 u `F-r(,,„\A-- 0P
Applicable Law: X. Section 404(Clean Water Act,33 U.S.C. 1344).
(check all that apply) _ Section 10(River and Harbor Act of 1899).
Authorization: -19.8t7boD '6 Regional General Permit Number.
Nationwide Permit Number.
Your work is authorized by this Regional General(RGP)or Nationwide Permit(NWP)provided it is accomplished
in strict accordance with the attached conditions and your submitted plans. If your activity is subject to Section
404 (if Section 404 block above is checked), before beginning work you must also receive a Section 401 water
quality certification from the N.C. Division of Environmental Management, telephone [phone]. For any
activity within the twenty coastal counties, before beginning work you must contact the N.C. Division of Coastal
Management, telephone[phone].
Please read and carefully comply with the attached conditions of the RGP or NWP. Any violation of the conditions
of the RGP or the NWP referenced above may subject the permittee to a stop work order,a restoration order,and/or
appropriate legal action.
This Department of the Army RGP or NWP verification does not relieve the permittee of the responsibility to obtain
any other required Federal,State,or local approvals/permits. The permittee may need to contact appropriate State
and local agencies before beginning work.
If there are any questions regarding this authorization or any of the conditions of the General Permit or Nationwide
Permit,please contact the Corps Regulatory Official specified below.
Date l ?"O
Corps Regulatory Official . LCD Telephone No. (9(o 5 I` Q93
Expiration Date of Verification /,)-3/ "O
SURVEY PLATS,FIELD SKETCH, WETLAND DELINEATION FORMS, PROJECT PLANS,ETC.,MUST
BE ATTACHED TO THE YELLOW(FILE) COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
CESAW Form 591
Revised July 1995