General Permits (1768)

►r -,
CERTIFICATION F EXEMPTI. 0 0 0
.Y N 13 1993
FROM REQUIRING A CAMA PERMIT GJ'Ai
as authorized by the State of North Carolina, (,.`jLJ LJ L—�✓
Department of Environment, Health, and Natural Resources and the Coastal Resources . ommj��jgq_____________
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name N1, I- l t 11 ►+1 �y2i1. f_ v A
Address
.I
City.� -
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project
V G A.0- Phone Number '11-1) (I( `It.
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
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
Zip
L-A
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 77 (SCALE:
.L)-
• I
r�
( Z
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
/'1? 7?
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203