General Permits (2037)

-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�aanlarea of environmental concern pursuant to 15-NGAG Subchapter7*:9 �t 1 I3 A JC.: J � 57
Applicant Name !"�1r � ��i `'-�1'G"$j � fe' Phone Number
Address i
City State Zip 2
Project Location (County, State Road, Water Body, etc.) ! -r,% ` ;i�.e : f !• �� r , r
Lee" r:
Type and Dimensions of Project U,,)Ilw
r
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.
I SKETCH (SCALE: 1(f/ S ) I
f'>/ "` !'
i t"l to
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 'adjacent
landowners-Eertifying that they have 'no objections to the
_ propos.bd work.
CA A Official's signature
Issuing date
Expiration date
Attachments- 1 &NeFth-Garoi'