General Permits (2904)

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 7K 020' r3C�=' 11 I - 1031 -h
Applicant Name N G V CT Phone Number L2 — -7977
Address 113 1 ) S �—
City State zip
Project Location (County, State Road, Water Body, etc.) F -- T�
The proposed project to be locateTand constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to I 1It,;i02WThis exemption to
CAMA permit requiremeq does not alleviate the necessity of
your obtaining any othe tate, Federal, or Local authori ation.
P
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.
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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
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)Au t 1T t ieo .
p�o�®s�rodr'�n:
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nature
CAMA Ofial's signature
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da
te ate
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Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203