General Permits (3053)

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s� CERTIFICATION OF EXEMPTI 0` 2 4 1996
FROM REQUIRING A CAMA PERMIT i..
as authorized by the State of North Carolina, ,r....r..+..r --shii+iiMlf
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
n an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant N Jf( �' 9 I L�_ "" Phone Number i "
Addr s - �i' F ,
City f. n'? r r(f. ,State zip
Project Loca inn (County, State Roa , Wat r Bod etc.
Type and Dimensions of Project (JIU X If I -( A /(. ' X CGl V_ I C U
r
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 i � ��� Jam. ;'d �P (.f r a I ;1 t%(.. A
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.
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.
(SCALE:
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17
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CAMA Off igial's si 'nature
Issuing d
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203