General Permits (3684)

C_E -TI:1GATt = -QF EXEMPTION z
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
inan area of environmental concern/ree-i p63.
Applicant Name -4 e. Phone Number
Address 0
City State NC AP Pb ru
Project Location (County, State Road, Water Bod , etc.) f u• a lei /p�so�� (i���
�w -I 2 c/
Type and Dimensions of Project
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement p �1 C-7K—@eG& This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
Jrc -
I SKETCH P
�, 1,',
This cification of exemption from requiring a CAMA permit is
valid for maps from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
(SCALE:
PIx7i/
pot,
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_writteR_staEer;*nt;has beano taine_dlro-adjae4nt
landowners -certifying -that they- have no-objections-te--the-
proposed word. -
Applicant's signature
CAMA Official's signature
Issuing date
2 _3� - `7 rn
7
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203