General Permits (2971)

CERTIFICATION OF EXEMP I,
�- FROM REQUIRING A CAMA PERMIT APR 1
0 1997
as authorized by the State of North Carolina, c
Department of Environment, Health, and Natural Resources and the Coastalesou ci
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .02"'"'"'""�� ""' ""•�""'�'
Applicant Name
Address Q;
City /'h
Phone Number 2zd- -S-9a3
The proposed project to be located and constructed as described This certification of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit re- valid for 9"ays-frefn the date of issuance. Following expiration,
quirement pursuant to-15--NOAG 7K--G203-This exemption to a re-examination of the project and project site may be necessary
CAMA permit requirements does not alleviate the necessity of to continue this certification.
your obtaining any other State, Federal, or Local authorization.
I SKETCH (SCALE: 11, n p , r , ) I
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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 Applican 's signature
development is exempted, will be in violation of the CAMA if there � --
is a subsequent determination that a permit was required for the
development. C� MA O' ' "l's sig a u e
The applicant certifies by signing this exemption that (1) the ap- � /9 �
plicant has read and will abide by the conditions of this exemp- Issuing date
tion, and (2) a written statement has been obtained from adjacent ; 92
landowners certifying that they have no objections to the Expiration date
proposed work.
aftA-Ctirrrent:-t5I�to°rtii'C�rotiria-A~dminis'tP�