General Permits (3049)

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CERTIFICATION OF EXEI
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and !
in an area of environmental cone'rn pursuant to 15 NCAC Subch
Applicant Name s, —
Address
DEC 1 2 1930
ources uommission
• • •wwwwww�Jwi�7!�
Phone Number�-
City k State t\ ` Zip
Project Locatiori County, State Road, Water Body, etc.) 1A ,.�
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 pursuant to 15 NCAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
SKETCH c
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.
�A
i I
1 7 t2.
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.
(SCALE: )
I
i
I
6 --K-w
Applicant's Oignature_ ``•.- eJ
CAMA Official's signature)
i,
Issuing date I.
r1
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT (_mJ
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 NCAC Subchapter 7K .0203.—
Applicant lyre �.�. !� L (� �.� Phone Number o
AAArune. i
City f _. A
Project Location (Qoutgty, Sete Wd, aW BoJX,
Type agd-Q) pension j oyProject
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 15 NCAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
WWWO i
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.
I SKETCH (SCALE: ) I
ltjq 4 t i - — '- - irl
?MA - L+ S i I (L)
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.
icial's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203