Gossett

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA•PERMIT. o
. .as authorized bythe State of North Carolina,,._ •
0, 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 Fe n r'-sr,��, .e -tr'4'' • Phone Number '70 4 . 1 12-�PI1
- Address • QI41 .. Ned to;r tc
City •CAn Ica\-3:'e.l .State , kJ(1) . - Zip 'Q di :it
' Project Location(County,.State Road,Water Body,etc.) 'lam,Ni iNe. h Li C t co vv+n.- i 11 :'i\�! "`e_. :-S-h°'e °-k O t .JA v'i I\c e.vA r 1,.. . prv,- I'd' rt e_J �. . 1
'Type.and Dimensions of Project 71Z.e_r c r o c- r nne 6 e k. _‘r.ci1 A1onel nhorel7 \e J
A'bou e.. rt\k.,n°rr M`re,k t..b A Ice-Jr . M1c\ Wei( , no nc J c o r c C e_ied « 'kR3
be- btlkkrc'ei ' irs. 1kig‘j tr e i A te;tnin 1d.)At-e-f'
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The proposed project to be located and constructed as described g 1 his 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 ' tp 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-. 1`+ -w,,,,,.- 141 C c. ..---,o
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 _ � j --
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is a subsequent determination that a permit was required for the nr'�
development. - CAMA O.fffiiciial's signature 1
- The applicant certifies by signing this exemption that(1)the ap- f ' (�' 00 4
plicant has read and will'abide by the conditions of this exemp-
tion,and(2)a written statement has been obtained from adjacent e r O..,i �'e-t.j (8 , • 00 1 . • -
landowners certifying-that they have no objections to the Expiration date •
proposed work. " •
Attachment: 15 North Carolina Administrative Code 7K.0203 ,