General Permits (1945)

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Applicant
Address_
City
Project U
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 pursug/nt to NGA&_Subehapter=7K .0203:
t`jj^��? Phone Number
)n (County, State Road, Water Body, etc.
State / AA' Zip
Type a d Dimensions of Project kee r rr' �- ',/ 1.1 ?�2_Tee- 1. ^.'r
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 1,5-.NCAC 7K::020&. This Axemption to
. CAMA permit requireml3nts 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 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.
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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, and42)awritten, statement,has`breenobtainedfrom'adIdL-6M
landowners certifying that., -they -have no -objections -to -the
proposed work.
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Applicant's signature _
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15•North Carolina Administrrative-Cod'e`7K V0'!l"'