General Permits (2958)

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G.ERTIFI=CA-TI -� N-O-F 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 pufsaant to,45-NCA43-Subchapter 71,:02@8-
Applicant Name __%r,:, i /:J�h r, s Phone Number3
Address ,ti ,� > -,:�
City State wc— Zip 21 fJ?---
Project Location (County, State Road, Water Body, etc.) := c; . /b/,. ,rE
f
Type and Dimensions of Project
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement puf9wwt<te-15-WAe 7K .020a. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
__'r a' ;
This cc�tificat& 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: ,, �,. ) I
� A c!1.4/rc-loj4(1 , i / 6_141
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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) a wdasmstatement has been obtarned-ffem adj'acant
Iandown..is.:certifying .that -they.. have no, —objections to --the
propued.;.work.
Applicant's'signature
CAMA Official's sign ture
-17--i'h
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203