General Permits (861)

CERTIFICATION OF EXEMPTION _ ^`
FROM REQUIRING A CAMA PERMIT i OCT 1 8 2000
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Redources� -EMENT
I in n area� of environmental concern pursuant to 15 NCAC Subchapter 7K .020i_ __.,r,,,,,MOREH t,
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Applicant Name d 0©+ Y1�V S / SSc:�. Phone Number s 3 ra(-
Address (0 L (-InX - LkrJ k-
City t State C zip l e) Cl
Project Locatiop (County„State Road, Water Body, etc.) D 0 4-- OLD fn� r I
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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 may be necessary
CAMA permit requirements does not alleviate the necessity of to continue this certification.
your obtaining any other State, Federal, or Local authorization.
I SKETCH (SCALE: )
CAJjA L
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.
7RO aT Nil
I�Prrti-►P �_-_
CAMA Official's signature
o
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

PERMITTEE'
LOCATION:
MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMIT # G
FIELD REP. �i' �16
PHONE: DATE REPORTEDLY COMPLETE:
DATE OF INSPECTION �.;►��s`scN'I
. W
1) Do thet
sured dimensions of the development differ from those in icated in the permit
YES/ ircle one].
COMMENT:
2) SEDIMENTATION & EROSION CONTROL:
disturbed areas? YES O circle one]
COMMENT: U t , L. 7L 1
3)
*01
[circle one].
workplat?
Has Permittee seeded, grassed, or otherwise stabilized all
: Is further investigation or enforcement action