General Permits (3439)

CERTIFICATION OF EXEMPTION 9�
FROM REQUIRING A CAMA PERMIT C,- i -s-
as authorized by the State of North Carolina, ro�
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.
Applicant Name r S f p 5� 0 7 o w4- H�AU -?
Addre s c/oV J
City {d �- State _
Project Loca on (County, State Road, Water Body, etc.) C -7 o k o rc'y
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The proposed project to be located and constructed as described
above is hby 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.
Phone Number'? / C/ " G �k " �?k
zip ri /
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.
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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.
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Appli'IAht's Vgnature
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CAMA Official's signature
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Issuing date
Exptration date
Attachment: 15 North Carolina Administrative Code 7K .0203

BROAD CREEK CONSTRUCTION
112 Creekview Court
Merritt, NC 28556
[phone]
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