General Permits (3032)

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 pursLtant,tcr-t5,,N'CAC-Su,bchapter-7K .0203.-
Applicant Name -,6��­­ , ­41. //6 e. t ­-?.4 i
Phone Number /A')
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Address oz: T4e,�,
City
State
zip
Project Location (County, State Road, Water Body, etc.)
Z
Type and Dimensions of Project
V I/
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement,pursLrant-to15 NGAC- 7K".0203, -This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
J ,
ISKETCH
This certitication'of -6xemption from requiring a CAMA permit is
valid for Wdays from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
el r_V - A) 714
(SCALE: 14e- ,
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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
*7
Expiration date
Attachment: 15 North Carolina Administrative Code 7K.0203