General Permits (2829)

V
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 1
in an area of environmental concern pursuant to 15 NCAC Subchapter-7K:0203: '. ra ' 4 r ,CA".
Applicant Name C , kr,,,c`ujni Phone Number
Address I u + a U,c- i-4 r i; i,, iz c
City State <_ Zip �A g ,X"k
Project Location (County, State Road, Water Body, etc.) ; K 0 ! I _S L4 .
Type and Dimensions of Project Ike-o 1c.L, A r:.s..
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 G203. 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.9day_s.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: )
f I I
4
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.bean•obtai-nedfrom adjaeerrt---
landowners--certifying... that --they - have "no- objections --to -th'e
propesed'work-
X':
Applicant's signature = '
CAMA Official's "signature
Issuing date
Expiration date
Attachment:.15..Ncutb..Caroliaa Adrninistrative-Cod-e'M:0203_-`"---