General Permits (3593)

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CERTIFICATION OF 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 pursuant to 4
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Applicant Name Phone Number 9ks 9y
Address 10 P__
City u� F \,,, , !- _ State NZip
Project o' S�1
Locatior'(,C`ountty, State Road, Water Body, etc.) t�,o�,,�„-Sr C',. Q...
�i O r� t'v-
Type` and Dimensions of Project
The proposed project to be located and constructed as described
This certification of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit re-
valid forfrom the date of issuance. Following expiration,
quirement pursuant to # This exemption to
a re-examination of the project and project site may be necessary
CAMA permit requirements does not alleviate the necessity of
to continue this certification.
your obtaining any other State, Federal, or Local authorization.
SKETCH (SCALE: No C )
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.
c---04"" \-h"�f
Applicant's signature
CAM -A Official's signature
Issuing date
Expiration date
Aftact= t�-15 j�lort -2m ina-Administrative-C-od-7K :424)a_

CERTIFICATION OF EXEMPTION
-Y
FROM REQUIRING A CAMA PERMIT 94A_
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 pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Ngme Do tj s A J k -,,.. f Phone Number 3 ! o - % q p -
Address -1 a
City 14- f 1-1r r U State '4 e" Zip 4a SA
Project Location ounty, State Road, W ter Body, etc.) ,0� _P
/J yL. eg 1,f .p
Type and Dimensions of Project -)Fes+ % �° S �- ? t /s�. l A-- W
Fa�
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.
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 f q,� / (` (SCALE: )
—�--r ---r-14,
-
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.
ure
CAMA Official's signatur-1
`7 //- G
Issuing date
T 5U-
Expiration Odle
Attachment: 15 North Carolina Administrative Code 7K .0203