General Permits (3644)

CERTIFICATION OF EXEMPTI.�� �.
_Y FROM REQUIRING A LAMA PERMIT C O �19� I
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Re o } }
in an area of environmental concern pursrranMn t5'W*e�Snbchapter 3K-0209-'^�'�"�""�w..�,�we�+��•sM�s!
Applicant Name C/,//I
Address r-2t'_!_ z `vk
City b- ,4, , < -,- V/. /
Project Location (County,
Road,
above is hereby certified as exempt from the CAMA permit re-
quirement -pursuant-to-1-5-NCA-C� 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 25 LXZ
Zi
valid for9fl-days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
I SKETCH (SCALE: lVon F- ) I
AS
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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.
Iry
Applicant's Applicant's signature
LAMA 0-. ficial's signature
be
Is in ate
Expiration date
Attachment.-15'Ncrth-Carolma'Ad-m"sfra }f e Code 7K .0203