General Permits (3027)

CERTIFICATION.OF EXEMPTION rdl
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-NO-AG SSt►behapter7K-:0203.
Applicant Name Phone Number `7J 7- dy 3 y
Address Vc7 u
City State /,,C. zip " f�
Project Location ( ounty, State Road, Water Body, etc.)
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Type and Dimensions of Project 1
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The proposed project to be located and constructed as described
above is hereby certified as exempt from the LAMA permit re-
quirement pursuant to 45,-N0AC 7K -.0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
ISKETCH
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).a.written statement has been obtained from adjacent
landowners- certifying that they have no objections to the
proposed work.
Applicant's -signature
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203