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CERTIFICATION OF EXEMPTION
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•P/Ssor NCGS 113A-103(5)(b)(5) .
Applicant Name jr "1 9c - Phone Number f/i' 8 SO 46 75-9
Address 19 fPQC/A. Pcnri K'7 ,
City fill/Y>- c 1 I s-Qctiyldi 1i,`I ril6V--\ State NC, Zip k4 if
Project Location(Cou nty, tate Road,Water Bop ,etc.)
1, 4%r1 k S au-, k► j a a bow 4ed fetes
Type and Dimensions of Project Y ' * 41,11(rVet"'‘'" 41-Ck4 -bah/7
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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Any person who proceeds with a development without the con-
sent of a CAMA official under 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. C A Official'ssi nature Q
The applicant certifies by signing this exemption that the 4, Al�aoa 6 �✓ 4/aczn
applicant will abide by the conditions of this exemption. Issuing date Expiration Date

•
.CERTIFICATION OF EXEMPTION •
. - FROM REQUIRING A CAMA.PERMIT
lit;.tutt1{;(11 J by itin Stlito of Mail;Cavan,. '
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