General Permits (3185)

-�r- C E.RTI FI-CAT ION 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 u.rsuant-to•,1-MGAG•Subcha erzlk!9W.
Applicant Name ,, f •'�
Addressi?y,
City
Project Location (County, State Road,, Water Body, etc.) _
Phone Number ` rY- 6_;-J -e IS
State, zip kfee)
Type and Dimensions of Project un�. s .���'+' " �•: `
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-NZAG-714 MOM. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This mortification of exemption from requiring a CAMA permit is
valid fd�9"ays from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
T. f e
SKETCH (SCALE:a.�.Z )
i
'PamJ J
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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
,'`s'9G
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203