General Permits (1986)

-Y
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 15 NCAC Subchapter 7K .0203.
Applicant Name 0 a r 1OWSM2Phone Number �� of / '-����
Address t; )
City F Q State zip
Project Location _Siate F; %�a or od /ept-c.) 6:
SITAI
Type and Dimensions of Project J ;7C
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.
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.
SKETCH (SCALE:
AeR� -
p .
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i
Am, nerenn whn nrnrronrtc with A rfAVPlnnmpnt 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)_1h -ap=
plican as-read..and will abide by the conditiorts of this exemp-
tion, and (2) a written statement-,hasb76;5n obtained from adjacent
landowners certifyirtg'"that they have no `obje�'ons_to.. they.
_propos`e-d work.
1 / 3�}l
Expiration date
...Attachm Gnt.:_35_ Nor4.h-Garolipa-Admipistrative-,Code-7-K--0203--