General Permits (2442)

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V CERTIFICATION OF EXEPwrrrp1 _L..
FROM REQUIRING A CAMA PERMIT
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authorized b the State of North Carolina
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Department of Environment, Health, and Natural Resources and the Coastal Resources Co i n
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in an area of environmental concern pursuant to 15 NCAC Subchalhft W ^ ~-
Applicant Name c.
Address Qy)� 1-V
Cityr,�..1\u
Project Location (County, State Road, Water Body, etc.)
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Phone Number c i7 7 fo �iti
Zip`t
Type and Dimensions of Project
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.
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.
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.
A piicant s signature
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CAMA Official's signature
Issuing date
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Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203