General Permits (1975)

RECEIVED
CERTIFICATION OF EXEMPT1Oi 'N'
FROM REQUIRING A CAMA PERMIT DCM-N4HDCITY
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,NOAC-Subchapter 7-K .0203. s S ��►-)', '> ;
to z a�
Applicant Name _I) t Phone Number �-tp l -
Address C�J t,c. , w. ,Cy
City S ` - � State 0 C. zip D
Project Location (County, State Road, Water Body, etc.) cu .,1 to -y irk
Tpe and Dimensions of Project
{ J 1 G' Lam. J 1 L•
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.
)(b)(t \
This certification of exemption from requiring a CAMA permit is
valid for•90 daysfrom the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
SKETCH (SCALE:
rY*NL1 ^,
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(Z)a written statemant _has .been.obtained.frarn.-adjacent
landowners, -certifying -that--they have - no ..objections --to -the-
proposed work:
5L)\., n c�
A.,tk�r,-I,c1 �V
K(�IGc.t tl���i S
:ant's signature
L Official's sianatu`re
c.:
Issuing date
J14
Expiration date
Attaehmznt: 15- North"C'a"P6iina Administrative-Cvd-e 7K-4203