General Permits (875)

CERTIFICATION OF EXEMP _
_Y rAUQO2QQ1('r 'J, L"')FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, GEMENTDepartment of Environment, Health, and Natural Resources and the Coa tal �ission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7
Applicant Name PAV t'7 IZU`> 15 Phone Numbe 1 t
Address I ' 0'. 1�
City 1 ' i � ter. (' � � 2-- State Zip
Project Location (County, State Road, Water Body, et .) "" G _1 tr S 1
i <' r' . 't t l.Y C" ice' C ` ► /
Type and Dimensions of Project
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. j
your obtaining any other State, Federal, or Local authorization. J
SKETCH (SCALE:
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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 s5i ure
development is exempted, will be in violation of the CAMA if there=
is a subsequent determination that a permit was required for the
development. CA 'O cial's sigTrature
The applicant certifies by signing this exemption that (1) the ap-
plicant has read and will abide by the conditions of this exemp Issuiate
tion, and (2) a written statement has been obtained from adjacent ')
landowners certifying that they have no objections to the Expiration e
proposed work.
Attachment: 15 North Carolina Administrative Code 7K .0203