General Permits (1946)

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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, 0c^lj,,, 1
Department of Environment, Health, and Natural Resources and the Coastal Resources Commi�on Ilk r1�
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K-:0203. i i �A- tot Sif
Applicant Name Phone Number 5s 1 \,
Address ► b,4 d
City State Zip d ci Pkkhy
Project Location (County, State Road, Water Body, etc.) - i 1 •Y
i i .....,- c( oc',,t k i- i)v Cvr. i..,,X
Type and Dimensions of Project LA a
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--NCA87K-6243: This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
SA - ! -s( bK i 1
This cc-tification of exemption from requiring a CAMA permit is
•vaaid for-90 daysirom 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, and (2) a-written-statement-has•been.obtainedJmm adjaQont...
landowners-ce4if)4ng_.that_ they.. -have. --no ..objections- 40--the
proposed-work-
X
Applicant's signature -
CAMA Official's signature
5 I .. " , �
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203