General Permits (2700)

CERTIFICATION OF EXEMPTI6WD �✓
SEP � l Mil
FROM REQUIRING'A CAMA PERMIT
as authorized by the State of North 6wolina,
Department of Environment, Health, and Natural Resources and the Coasta RVpWg"-PPmmission
in an area of environmental concern pursuant -to 15 NCAC Subchapter 7K :4203.
Applicant Name Phone Number .806� l ib ` 14bv `r
Address .) A i LA si :x r 1 A. v c
City. State 11A Zip .� v
Project Location (County, State Road, Water Body, etc.) i 1 �i k , ,,G i ") { , , I. ; A s „, ; : �, i it
le. c�
Type and Dimensions of Project 040lo L-L. li- „tC f lo, 0,'�' c re, YLI -1„ 4'_
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%f!- IVY '-Wit
This certification of exemption from requiring a CAMA permit is
valid forgo days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
SKETCH (SCALE: ;,• )
1
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I�p14vt. �l41 ?uf M
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 from-adjaGea_
landowners certifying that --they' have --no -objections-,ta-'4he—
proposed-work.
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Applicant's signature
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CAMA Official's signature
Issuing date
i lti
Expiration date
-- Attachm ent ,4,5-North. Carolina -Ad ministrative-Co'M7K'.`b2-0r