General Permits (2521)

-�r- 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-7-K :a203: & 1. - 113A �- ) u� (Swv!71�
Applicant Name ��, � Phone Number Sl)\ 1)(0 t - 'r31i
Address P` 0 i�>X i �,-J4
City '.. ( , ,. )+ State i.j C Zip � ,7k y K
Project Location (County, State Road, Water Body, etc.) _ Li . ; ;? c (!U
Poc
Type and Dimensions of Project �, �. Z y U,,�, i- , . j „
_ 1.1 44, i!t t �U"A�_. C'vi� (G ?-.L /7. * r. _ t, '
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.
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.
LSKETCH (SCALE: ; )
C ;C,\JF A.,Nt%) it
�\L.ON, r+� � Ari4 � 9.lj(16,1
141
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 has been obtained frottt-ftdjacent
landowners- certrfying that .they-•haue...no.- objections. -to—the
-proposed.work.
Yr-,
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put ", Zr .,. %,t 'Aswc.
Ppb 1!
Applicant's signature
CAMA Official's signature
Issuing date
F:
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203