General Permits (2156)

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CERTIFICATE OF EXEMPTION J
FROM REQUIRING A LAMA PERMIT vDEC 1 1 z0l2 T 4") 02131
as authorized by the State of North Carolina,
Department of Environment and Natural Resources and the Coastal Resorts mission
in an area of environmental concern pursuant to 15 NC -AC -Subchapter 7K %i
Applicant Name ����"�!'� l%1i/ �'f��._, rr flid%' z/'��1�h Phone NumberE"C�?�
Address
City ! vs, 1; State ,Q%� Zip
Project Location (County, State Road, Water Body etc.)
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit
requirement pursuant to 15>CAC 7K- . This exemption
to CAMA permit requirements does not alleviate the necessity of
your obtaining other. State, Federal or Local authorizatio .
SKETCH
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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.
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Any persorrwho 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 certifying that they have no objections to the
proposed work.
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CAMA Official's signature
Issuing date
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Expiration date
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Attachment: 15-North'Carotina Admints ra the=ode 7K'
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