General Permits (3066)

-� CFRT F1,0AT40 7­0F EXEMPTION cog/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-#5-MeAemftbchapter-7K :02e3.
Applicant Name j +r�1_., i( ;' 0►C,
Address
City�J��o�
Project Location (County, State Road, Water Body, etc.)
Phone Number 2 V U- ? c 9f-
L. Zip
Type and Dimensions of Project /C,G.c Tf r e ' a Xv h;A4
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuaaiAa=F--ht@A6-7K-10203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This 6 ti if cation of exemption from requiring a CAMA permit is
valid fA�_days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
SKETCH (SCALE: i4a- )
Ij�GICF O /CCrG,�.jjf!/u�. Cam. �Z����ji%� 1'Si t✓•o
Gtj�.Cc.�',
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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 J
J
CAMA Official's sign4t6re
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203