Warlick

CERTIFICATION OF EXEMPTION
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
r - in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
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Applicant Name o ►� p, C� I/VQ j A9j� Cr 50 ` Phone Number .�/o — 1.3 —OZb S
Address ILA ► ) 5 ; ouoe T %
City ]a, C k : ' f I State /VC_ Zip -z
Project pLocation(County, State Road, Water Body, etc.) Pend a /Cow,-re / .1O 2 �1� o r;,erg B►ve{ .
Type and Dimensions of Project T?. eelAcc- -;! -.3s �,.� ;F. �so-k ('enlace
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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 maybe necessary
CAMA permit requirements does not alleviate the necessity of ) to continue this certification.
your obtaining any other State, Federal,or Local authorization. nk 0, O.
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Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assumption that the Applicant's signature
development is exempted,will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development. CAMA Official's signature
The applicant certifies by signing this exemption that (1)the ap- 4/ 0
Issuing ca
plicant has read and will abide by the conditions of this exemp- t
tion,and(2)a written statement has been obtained from adjacent � ��
landowners certifying that they have no objections to the Expiration date
proposed work.
Attachment: 15 North Carolina Administrative Code 7K.0203