General Permits (2514)

i 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 an area of environmental concern pursuant to 15 NCAC Subchapter 71K:02-0 `;, , j } S�; i;,�(ti irhi� )
Applicant Name Phone Number",) , a l a A - a �►
Address ir'_C; trvc t* , �, • w�
City ' 4 State zip 4
Project Location (County, State Road, Water Body, etc.) 5'? 's'
Type and Dimensions of Project f '
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 NCAE 71K •.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, S ) I
Ex
f& r c..1-
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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
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 (Zpa-written-statement has beerrobt-aired'fPoin adjacent
landowners- oertifyin'g`"thaf_ihey fiave no- objections to the
proposed-wark .`_.
• �i.: 1 hti• r � �
/v . l
9A ii*''r
Via
'Applicant's sign}ge�
CAMA Official's signature
Issuing date
Expiration date
Attachment''iSlVorffi'Carorna Ad`m0Yistmftu-Crsde"7"203

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 an area of environmental concern pursuant to 15 NCAC �. j , (l3A -101(' YbV S
Applicant Name R1c. ha IL 7 Per. Phone Number6sa) .13A-
Address 110 Wo it F s
City k State AU C zip d 5
Project Lo ation (County, State Road, Water Body, etc.) SR 0 f3(ya. , f 10 L-C. r b f, v. , Ho ki k G
gr��f V,ek, A(_rcS SAD ,'L0J 1*G � rurr�1'.•c k Cn,r,10 Nulls
a R
Type and Dimensions of Project _ }
0n'� f, e .0 1 t►t +h n the ertG
� � ►a,lf4lo9 .:
The proposed projectto be located and constructed asdescribed This certification of exemption from requiring a LAMA permit is
above is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expiration,
quirement pursuant to This exemption to a re-examination of the project and project site may be necessary
CAMA permit requirements does not alleviate the necessity of to continue this certification.
your obtaining any other State, Federal or Local uthorization.
G.S. 113A-to3Cs�C�X�� ,
SKETCH (SCALE: N T S )
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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
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 (2t t
ey ave no o lec ions o e
f~
-CAMA Official's signature
Issuing de
3-31— 40IN
Expiration date
-A 5n : 15 NOrtnar i