General Permits (2127)

CERTIFICATION OF EXEIVIPT10N
FROM REQUIRING A CAMA PERMIT SEP 2 g 2011
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Qoastal Resources Commission `
in an area of environmental concern pursuant to 15 NCAC Subchapt ?fbi�Y - iy,s. i'�3r� i��ish\t✓S ;
Applicant Name lot- le, I" Phone Number (,asaiSg9-a'�uI
Address t I )- Or shw r 1:n rya
City "J State ti c.. zip x3g 4 9
Project Location (County, State Road, Water Body, etc.) o„y scr Z :5/ 0 � L ut a -4,
Type and Dimensions of Project to kvik , ►2c�;l�cp_ �'x.U' s._i,
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-7-K ;O2OS: This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
11 �-rW Xs�)fS�
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:
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Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assumption that the Applicant's sig
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development.
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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-wa4terrstate-sent-hasbeenobtained4r djacent
Tand'own-ers--certifying--that -they- have- no—objeetiens--to--the
proposed -work:
Issuing date
Expiration date
re - - -
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