General Permits (842)

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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
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant, Name
Address
City
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 15 NCAC 7K .0203. This exemption to
LAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
Phone Number
State
Zip
This certification of exemption from requiring a CAMA permit is
valid for 90 days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
SKETCH (SCALE: )
Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assumption that the
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development.
The applicant certifies by signing this exemption that (1) the ap-
plicant has read and will abide by the conditions of this exemp-
tion, and (2) a written statement has been obtained from adjacent
landowners certifying that they have no objections to the
proposed work.
Applicant's signature
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

FPDM : DAJID PARRI5H CONSTRUCTION PHONE NO. 3.36 626 3330 Ppr. 25 2001 3e:06Ah1 F2
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FRO : DA'JID PARRISH CONSTRUCTICN PHONE NO. : 336 626 3330 P.pr. 25 2001 36:06AM P3
Adjacent Property Owners
Approval for Bulkhead
l J U I L-L (. '4A located at 2 0 7 Straits Haven Road
approve and agree with the attached proposed bulkhead to be constructed on
the lot of David Parrish at 209 Straits Haven Road_
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Signature

Adjacent Property Owners
Approval for Bulkhead
iacated at Straits Haven Road
approve and agree with the attached proposed bulkhead to be constructed on
the lot of David Parrish at 209 ;traits Haven !Road.
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Signature Date