General Permits (2148)

Applicant Name
Address.
CERTIFICATE OF EXEMPTION
FROM REQUIRING A LAMA PERMIT
as authorized by the State of North Carolina, SFP 14 ?p;
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K
LtG0 I-ho < "/v1U Phone Number _ WAZ c ter.
City
Project Location'(County, State Road, Water Body, etc.) _
�!Y i[.f lc.\ Vrmj Ic_ t(,Sti It r�
{ t js4� v
Typb and Dimensions of Project
Y ,.
t1TT I U0 Ct,l
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit
requirement pursuant to 15 NCAC 7K .('2-o"2-.. This exemption
to CAMA permit requirements does not alleviate the necessity of
your obtaining other State, Federal or Local authorization.
M (. ✓ 1 r'I
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: i \ � )
1kw
L j
IN L-4\ K(5)
`E'i�L'� I IrAp
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 4as-been•obtained frcrtradjacent
landowners--cedifying -that- they ---have -no.,• ob*tions-"-W-the•
proposed work_
Applicant's signature— _) I
CAMA Official's signature f
Issuing date
1 �G f 1-7-
Expiration date,
Attachment: 15 North Carolina Administrative Code 7K