General Permits (1908)

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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 74<U2e-9-.-- G, j. 113-``A - I OUS b)ec
Applicant Name Frr. K 7 6111 11 K i tX " I2. r�C re t✓« , Phone Number L Sit 114
Address 84s
City _ - , ti`,L, State zip a
Project Location (County, State Road, Water Body, etc.) +4 S ►eu+rc !., oo4 C4 � 1,. i 4 d o b
'.SwWei
EWthr�
Type and Dimensions of Project Rt n is u A li�td : - +. vV� At [ !lwl% e"t
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 1&­NCAC-7--:0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA permit is
valid for go days from the date of issuance. Following expiration,
'a re -exam ation of the project and project site may be necessary
to continue this certification.
SKETCH (SCALE: I" ,y ; )
✓— 1 �y � V
BOG j}k i 1
Vit.t.\f witXCI
�A�i1-,�r,�.c► luci y 4� P,;r SLctpl�ur!ur��-- `�' (�;.T.�.�
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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
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 writtenstater rlthas:been obtainedfirom-a-djaLqUhT,
l landowners-- certifying- -that --they-- have no objec�orrs--to•--the---
preposed"work.-
LAMA Official's signature
Issuing date
Expiration date
Attach.ment:-15--Nort-h-Garelina-AdministrattGe Code 7-1 ':0263