General Permits (2712)

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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, SFP
Department of Environment, Health, and Natural Resources and the Coastal 4, 044 Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
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Applicant Name lr'bPat- �t j -viet, t. h Phone TqtirWer r? Ct
Address
City State AI Zip Y
Project Location (County, State Road, Water Body, etc.) `_ ,A AA E
Type and Dimensions of Project a_bse "L A ;fJ' X 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.
tris:oextiftsatkm.-oi=ex-ernptkm.trom-requiring-a CAMA permiWs-0.0
lrtfxsK9:ys"fxorrtEtedateofiseuanee. Following expiratioA;�
a re-examination of the project and project site may be necessary
to continue this certification.
SKETCH )- t�VJ (SCALE:
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, an-&J2�,a- written-state:me-nt-hes-beerrobtained:f:rom-adjacent
landowners c,ertif�!ing:that-they:,haue=no;=obj�ctions�to tkte
proposed -work. : e
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Applicant's signature
CAMA
.�Off icial's signature
Issulind date
.4
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203