General Permits (3389)

-`fin
v
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, OCT 14 199$
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
r•.
Applicant Name �. ' Phone Number -�
Address L`� i a
City State zip ?
Project Locgtion (County, Slate Road, Water Body, etc.) '.a�
Type and Dimensions of Project
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.
Y �_
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.
I SKETCH (SCALE: Q ! � ) I
L4 vY'� o ��� "T��--�•Y�Gt
�'• .;
{ tvT
o-
i r �ti c T u' tab 6i i.i Cs s'S>:
AT 'Incitf Lo ca
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.
; P- � i I W$'YV
09A<. _3qoc) /7
ne
1r-) C'�; -
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203