General Permits (3394)

CFRTlFiG A�90 WOF 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 trapte Kr-D
Applicant Name d", r;st)! -/ ��. /r %. r� . /t ; - !,' r s�•� •�,- Phone Number c,62 a--
Address
City _ ffar{i D." State
Project Location (County, State Road, Water Body, exc.)
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Zip
Type and Dimensions of Project" �r f=!'r / r��� fC�r-.• / �_{ n. �r';%r,r,.tr'.,
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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 exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
d /:— %,
ISKETCH
This certification of exemption from requiring a CAMA permit is
valid forU@-d*s from the date of issuance. Following expiration,
a re-examination of the 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-wr4t"statent r has-been-obtainedfrom-acfjacent
-tandrnrorrers-certifying-that-they--have-no--objectio ns--to--the-
-proposed-wGFk-
_• i
int's signature I
Official's signature
/U . fkc
Issuing date
9 le - `115'
Expiration date
Attachment: 15-North Carolina Administrative Code 7K .0203