General Permits (3239)

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CERTIFICATION:OF EXEMPTION.
FROM REQUIRING A CAMA PERMIT 1
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as authorized by the*'! tat a 'of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resou1. rces Commission `
in an area of environmental concern pursuant to
Applicant Name Number
ee �, ,5� Phone Number9la ; vl1 • S—tS
....•Address �C] 1�,md�� - - . -
City State_ N :Zip
Project Lbcation'(County, State -Road, Water Bod `etc
tilc�r�
.Type and -Dimensions, of Project
The proposed project to be located and constructed as described This certification of exemption from requiring a CAMA permit is
above is hereby certified as .exempt from the CAMA permit re valid for from the date of issuance: Following expiration,
quirement pursuant to6-p�6�S ; Thisexemption to f a re-examination of the project and project site may be necessary .
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your obtaining any other State, Federal, or Local authorization.
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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 plicant's signature
development is e)empted, will bd'in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development. ' - UAMA Official's signature O'
The applicant certifies by signing this exemption that (t) the ap- ad
plicant has read and will abide by the Issuing date conditions of this exemp- '
tion, and (2) a written statement has been obtained from adjacent "M 7�\No �
landowners certifying that they have no objections to the Expiration date
proposed work.
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