General Permits (2963)

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FROM REQUIRING A CAMA PEI
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Re
in an area of environmental concern pw"ant-W1FY-
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Commission
Applicant Name /!- r% 7—� a // Phone Number 9"7- &w _
Address fy'C� cs k /60
City ,o,< > State w C Zip pkS"1'S
Project Location (County, State ,Road, Water Body, etc.)
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Type and Dimensions of Project fyr-� /i �:_ . ''n 'x
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The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This �'rtifi-d-cation of exemption from requiring a CAMA permit is
valid fbi' tys 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:
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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 written=sad' acent-
landowners�,,oertifying tFrat=4-hey have rro -objections to= the -
proposed -+work.
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Applicant's signature _
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CAMA Official's signafure
Issuing date
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Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

State of North Carolina
Department of Environment,
Health and Natural Resources LT•
Division of Coastal Management a
James B. Hunt, Governor y p� H N F1
dft
Jonathan B. Howes, Secretor
Roger N. Schecter, Director
Attached is a Certificate of Exemption From Requiring a CAMA Permit. In order to
validate this permit, please sign all three (3) copies as indicated. Retain the yellow copy and
the attached regulation (7K .0203) for your files and return the blue and green signed copies to
us in the enclosed, self-addressed envelope.
Your early attention to this matter would be appreciated.
Sincerely,
1e _TUK)dn��
Field Representative
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Enclosures
P.O. Box 769, 3441 Arendell St., Morehead City, North Carolina 28557 Courier #11-12-09
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