General Permits (1934)

its
Applicant Name
Address
City
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 71K-02M. `i S
t r
(� iidIi k I'a( bl))a � (,►r�rAKS11'k i6 dl Lhif%YY Phone Number 111j,1,;,Ci�1-
Project Location (County, State Road, Water Body, etc.)
Zip � . 4(:'�'i - 177" ,
Type,and iDt imensionsof Project kkt 6i( (CtY 1�_—x t�;�1t�YC'� i ?hG
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 ,alfevfate the necessity of
your obtaining any other State, Federal, or Local authorization.
1�I
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.
I SKETCH (SCALE: 1 rh ) I
4 . ! �,i . I111 ! , i� �t i ! ! Ii Ik1►li �.
i
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 i+as-tree"btained-f-rorn adjacent
--farrdovnTers "carping --Mar tlfdV--R ve no b"6jections -lcr `the
prQposed-work.
�tiUUitAP
signTature_
CAMA Official's signature
C
Issuin6 date
Expiration dat
Attachment: 15 North Carolina Administrative Code 7K .0203

Jul IJ un ue.J, k) I lumu y- ICJ 4tDz LO.7b p.z
0 0CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the 5toto of North Catal ina,
�, Department of Environment, Noalih, end Natural Resourcgs and the C4a9•al irieaoureos_1 �D� "f17 a f
�= In an aroa of Anvlronmantoi concern purouant to t6 NCAC Subchapier 7K0110,3
+� 4
Iw 1 .I'1 11 't_ f'1 r.+ nnw r'.., ZAArTl-el Q,'II 66tt[hr/_ Phone Number ID, p12�J
Applicant Name ,1Y
Addros
city wetter doa g, Body,
Drnlart l AC1110 tCour>tY, slate � i_
nsfons of Project
rho proposed pro)cot to bo'rzcated and ccn9truclod as 6ascrlbod
above la horoby Crl j o1 as exempt from th TOAs exalrrnpt o�rto
qutramont pursupnt to 16 NCAC 7K
CAMA permit requireMente dooe nol I to the necessity of
your obtaining any othor 5iata, Fadorol, or Local authorizalion,
T.110 Cortltication of exomptlon from requiring a CAMA pelmlt i9
,ralld for 90 do a from tho date at Issuance. Following explrallon,
a ro•oxamination of theprojoot and project 51to may be nocuesary
to contlnue WE Curtlflcutlan.
(SCALE: q:
SKETC4
t
4, '
i
Anorgon Who coods
sort of a CAMA official undertthe mistaken aeoumptlont that the
ea subsequo tdolerpirinatlonbhat ais axam, wille Iniion paatrmn wiaseaqui odthCAMA liorlh�
is
developrnont,
Tno appllcart cerilltas by alerting this oxOmPticr' that (1) tha op•
plicanl has rend and wi11 abide by the conditions of thin gxempf
lion, and (2 uve o
ra
Issu}M� tl a r
I
Expire', n da'
Attachmort: 15 North Caroflna Admirletrat'we Coda 7K .0203
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