General Permits (1962)

CERTIFICATION OF EXEMPT
FROM REQUIRING A CAMA PERMIT JUN 2 9
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Re L
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0 03. MOREHI
Applicant Name �J. D&oa
Address . i 40 )6,e kY4A 4 ,,,
City'
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project
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 alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
• E: N 1
Phone Number `F
State _
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: i . Z(_, )
Chi N � ILI
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-writtenstatement has beennobtain. ed.from adjace.mT.
--lando wners , certifying -that they have no objections- to the
proposed work.
16
uYTArc
Nj
14 T,- -
Applicant's signature
CAMA Official's signature
'i L I / I z
Issuing date ' %/ J
C) I 1 1 ! I -L
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203