Byman

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT G � 5u�1140("4
as authorized by the State of North Carolina, /e
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. U L,
Applicant Name FA 3y A- •
Phone Number! 9 /`() ')
Address /I7E74-14A-- /47,P4 /b /?
City State /i t' Zip d-nv/
Project Locatidtr(County, State Road, Water Body, etc.) 3,00 . 5/4t t."-( A joRTH
72 S4 1 3F 4-e II Ar-li/ /4 7/14,7S C o 1 F4 , o ti S/u w
Type and Dimensipns of Project / 1e>f ri&.(L/ 7 4t II ►3t4 I rd o z;1 "/i o tc-
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 t J1 U.5 to continue this certification.
your obtaining any other State, Federal,or Local authorization.
SKETCH (SCALE: 4,14
44- 5-GC A/415th f) (0/V W,-h iv 5
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it,0 36z 1 4 ,) /m-'t 0CI L P7 /4/< PR
N 1d , / 30, .300
if A iOn.6;fi u S 0 K ,0/0 S/ /
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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 App'c nt's sig ature
development is exempted,will be in violation of the CAMA if there I
is a subsequent determination that a permit was required for the
development. CAMA dfficia's signature
The applicant certifies by signing this exemption that (1)the ap- //f
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 `1 30 —0 t
landowners certifying that they have no objections to the Expiration date
proposed work.
Attachment: 15 North Carolina Administrative Code 7K.0203