General Permits (3669)

' 1CZ`t
C�.F���=�"h_ EXEMPTION % � j
FROM REQUIRING A CAMA PERMIT �1�
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 .pu;nt toA5 NCAC SubefTaMer-7"M3 -
Applicant Name 4lever
Address
City
Project Location (County
Type and Dimensions of
Road, Water Body -etc.)
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement purse4ant4o, 0-AO-7—K .(263r This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
State
Phone Number
Zip .06sco
This certification of exemption from requiring a CAMA permit is
valid for 9O-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: %(`p,,rr. )
;P /e e4,-1-Gf g 9
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.
A�Plicant's signature
/o.,/ r., Xa /
CAMA Official's signature
Issuing date
3/_C/7
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

BLACK(3EAQ,0 SAILING CLv6,4TD. PPOPEkT y \\, I
RJPC17A51 D F,POM W,L, FLvUJE.<S °FPT /988 \�
NDUS E
\ I pU«
PADDING
UPPER BROAD
L . r-La WOE ,5 DOCe
Soo /
�'x/sSki5'
, SLI=(--l
P/EI2 --1
UJ�
r
)U NG
�' PICK/C I
Dp/VE' AyAy (� E«K
BRA VEL) 1
DRY BEAT SiU,<�/iCac ,\\
BlACkBE/)rSrilLif"JG CL J`,�TO.r"-P.C�PE:�; r�
PRDPE,�'Ty /AJE 50V,VDR/ES AA)D
w/,l CY J. STE MEW'
/S'SE7' 8�1 Ck'
f` P;I
ZOLD
EXlsrin)G \�
WATER LEPTHS !,
/VATURA L
WATE P
s� ,rgs FL0"N