General Permits (3520)

CERTIFICATION OF EXEMPTION
_Y 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 ��� 1
in an area of environmental concern pursuant to 15 NC�AC-Subchapter 7K .0203: fU-. : • o - ii
Applicant Name &,,J t✓ t 0 t'_. A) i � � Phone Number 33c -_. '� I
Address_ /` L% �/�:ri I-
City 71r.) e t; :-P State C zip 7 y6
Project Location (County, State Road, Water Body, etc.)
ie
i 1c' t V r t, rt r c` ; /� >w.: 4 �� L4 #V �oL,
C tr-Aar�K
Type and Dimensions of Project S7- r ^� , / k'yk/'
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 NGAG7f-:0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization. !!
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 S (SCALE: )
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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 st'atemen1 hasbeen-obtained-from adjacent
landowners,certifying'-thlafi-they- have-no--objectionsAo-•the
proposed -work:'
Applicant's signature
CAMA Official's signature
,, /y ��
Issuing date j
Expiration date
Attachment: 15-North'Carolina-Administrative Code7K :02-03