General Permits (3621)

1 vI2 Y
G EW-- GA GN= EXEMPTION
—� I O rc
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•putseant-�GAG-Svbehaptef-7K.X243.—
Applicant Name /r011 ill
Address 23 I
City-11*7144410
Project Location (County, State R(
Type and Dimensions of Project
s
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pmsua ± -e289-This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
1��r-
State
Phone Number 293- 6 VK q
f
Zip Iflrf
/��✓
This 6190-dets
ification of exemption from requiring a CAMA permit is
valid 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-stateme*4asJ; ea btatne Irorm admen!
Iandowneism-cogifying-fat--t r-have--n<�--ebje�to-the—
proposed�mrk.
Applic``,a-nt's signature _
CAMA Official's signat e
f- 2- 96
Issuing date
2- 3 / V
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203