General Permits (2783)

-Y 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 i
in an area of environmental concern pursuant to 15 NCAC Subcfiap`ter K :U-203, A/6_&� � r1. A- le7;)d F
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Applicant Name mil, . *���lt1_-, j i ,�� ,� . i/�I:�? Phone Number ,-
Address d( t-�V
City r # ' State A,1e- zips, !, �
Project Location (County, State Road, Water Body, etc.) 4;413 rD
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i ype ana uimensions or rroleci t -r r` .� -r _ f s - t
The proposed project to be located and constructed as described
above is hereby certified a exempt from the CAMA permit re-
quirement pursuant to 1�5', CAC:7K MG3,-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:
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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 Applicant's sign ure
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development. CAMAOfficia g6 ure
The applicant certifies by signing this exemption that (1) the ap-
Issuing date
plicant has read and will abide by the conditions of this exemp-
tion, and (2) a -written statement has been. obtained, fro
landowners certifying- that -they 'have "rfo' objectiqps t Expiration date
.proposed work. -
Attachm.ent.* 15-North Carolina�Administrative.Code 7K .0203