General Permits (1953)

O
Applicant Na
Address
City
Project Loca'
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 1-5-NCAG-SVbche*pter7K-0203.�,l
5_1�
Phone Number I 5""ti,�
Type and Dimensions of Project 911, ', Milo--
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 15- NC�\G=7K��:02Q3: This exemption to
CAMA permit requirements, -.does not alleviate the necessity of
your obtaining any other State, Federal, gf Local.au2horizatiam,
r A'4141 71i l.f•fJ ai J� %,.
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: /Jj7 5 ) I
tX/
17
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 obtained from adjacaMl-"
landowners certifying that =they -have no" objections' to -tie
proposed work.
Applicant's.sig4ature f f
re
Issuing date '
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203