General Permits (3270)

CERTIFICATION OF EXEMPTI
FROM REQUIRINGA I APR 0 1997
O A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Re
in an area of environmental concern pursuant to 1. -NOA( Subchapter.7.K--0203:
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Applicant Name �V Q sn 1 Ur K, Phone Number
,
Address _L;:a �L)
City \(' , State IVY zip i nIQJ
Project Location (County, State Road, Water Body, etc.) (.) .�� `-i4ry a? hi�.��.�•
Type and Dimensions of Projectt Sv-uc 11' X, ' CXS k, S ':
cR, ',1v` _�v�-.. �, �\;,..,.. tr. 3' a to �1c�\•,,..., G 1)• �'tiC �c2ch.��•.�V� �.,.#�, Lr. �o � tLi 't.:;�_!t
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to"l-S.NCAC--7K-.020.3. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
17- CLIti
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:
tii
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.
­40. C.- P, ..r 4 k `. 4 r, Q
�... s ��a 0.. �70 Al •w t G k Ck
Applicant's 6ignature
CAMA Official's signature
\ N) 11�K \. c,(—)
Issuing date
Expiration date
"..-Attachment: 15`t ffM-Caro iTifvet dministrative-Code 7K .0203