General Permits (1990)

CERTIFICATION OF EXEMPTIOI%cEr,.
FROM REQUIRING A CAMA PERMIT
S,�
as authorized by the State of North Carolina, / % �1�
Department of Environment, Health, and Natural Resources and the Coastal Resources5 C?if>+rfiission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K 049k,
} L' MND cl� �,! / 7� `/ Applicant Name A U&- 7 Phone Number f
Address
City Stat Zip
Project Location (County, State Road, Water Body, etc.) c '�
r / /
Type and Dimensions of Project v 1C J 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 .0�03. 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.
!l
SKETCH (SCALE: j ^ ( � )
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 writtenstaterrteat-has.beea obtair4edf;om�adjacent-
.Jandow.nars..-oegffyipq-that--they- 4ave•--no-objeetio+ts_..to-thy:.
_p.ro{aGsed-work.
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Expiration date'—
Attael�rrient; 15-No�th�Esralin�Ad�rirHst�at�ede-�K :Ei203�