General Permits (1888)

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CERTIFICATION ��—�����k � ������ �~��— EXEMPTION
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'����YN ����U|�|N,� ���yN� ���yN|T
FROM .^^.~ REQUIRING "..~^ . . ~^,^.,°. PERMIT
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ooauthorized bythe State ofNorth Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
\nanarea ofenvironmental concern pursuant to15NCACSubchapter 7K.O203.
ApplicantName Phone Number /
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of
The proposed project 1ubolocated and constructed oadescribed
above is hereby certified as exempt from the CAMApennh re-
quirement pursuant to 15 NCAO 7K .0203. This exemption to
CAKAA permit requirements does not alleviate the nooeaohy of
your obtaining any other State, Federal, orLocal authorization.
This certification ofexemption from requiring uCAMApermit is
valid for SOdays from the date nfissuance. Following expiration,
are-examination ofthe project and project site may bonecessary
\ocontinue this certification.
SKETCH (SCALE:
Any person who proceeds with odevelopment without the con-
sent ofaCAMAuffivalundorthemistakenaaoumptionthattho
development isexempted, will boinvio|ationofthoCAMA8thee
isasubsequent determination that apermit 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
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K.0203