General Permits (3174)

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Applicant Name
Address .b )o
City
Project Location (C
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
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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_pursuantto-15,NCAC Subch'a'P1e7 7K _0203.
Phone Number bW V7 2 v
rI ' State
State Road, Water Body, etc.)
Type and Dimensions of Project /� �,' ct•7 .� per/ fir,.sr• ('
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement purswent-to-t5,NGAG7K-:020,3. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
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.
SKETCH (SCALE: i; )
�,�. �.�..� . 4-' •ref �%i �! i2f"t� ��; r � � S a ,h.e:•��
�„;�t n�• �� � d; , i : 6v� 7%/_r'�,/�v�*.j�.i ��I.4� fT.,f �_.3P;J. �.
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 ' hare- no objections +to.-_ahe,
proposed wor*_,.
Applicant's signature
CAMA Official's signature'
i J
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203