General Permits (3571)

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Applicant Name
Address
City
Project Location
CERTIFICATION OF EXEMPTI 4
JUL 0 8 1997 13
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FROM REQUIRING A CAMA PERMITas +
Department of Environment, Heal h, and Resources and the Coastal Res& ttes C m,
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p� es Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.0"'
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unty, StateRoad, Water Body, etc.)
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Type and Dimensions of Project 1 (1 ,,rjCc L
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.
State
Zip _
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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 (SCALE: QOT Tb )
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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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Applica sig u
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CAMA Offic'i's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203