General Permits (3302)

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CERTIFICATION 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 Resd�rces Cmi�3fCT
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name /�xJ� e01'.Wrt1V 17-,C Phone Number
Address
City State C Zip
Project Location (County, State Road, Water Body, etc.)
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Type and Dimensions of Project ZV
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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 NCAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
,0�6C-
This certific Eofthe
xemption from requiring a CAMA permit is
valid fo 0 days the date of issuance. Following expiration,
a re -ex n project and project site may be necessary
to continue this certification.
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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 nature
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Issuing date
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Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

TOWN OF ATLANTIC BEACH
125 WEST FORT MACON ROAD. P.O. BOX 1 O. ATLANTIC BEACH. NC 2651 2
(91 9) 726-21 21
MAY 1 6 1998
AbJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I ,gn perty adjoining 4-�ICt.il4tt 8FQCh `s
property located at (I S'fOdl 4tl,�f , N. C. He has described to me as
shown below, the development he is proposing at that location and I have no
objections to his proposal.
Description and/or drawing of proposed development: (to be filled in by
individual proposing development.)
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signature / Xn,,, l
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name
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phone number
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( vc- eo-/14 164)

TOWN OF ATLANTIC BEACH
125 WEST FORT MACON ROAD. P.O. BOX 10. ATLANTIC BEACH. NC 28512
(91 9) 726-2 1 21
MAY 0 6 1998
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
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I hereby certify that I o property adjoining 4-41 Li 4t t 3each s
property located at n , t/I a -too 411e., N. C. He has described to me as
shown below, the development he is proposing at that location and I have no
objections to his proposal.
Description and/or drawing of proposed development: (to be filled in by
individual proposing development.)
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signature
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name
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phone number
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