General Permits (3720)

State
Phone• ' ti
Zip
CERTIFICATION OF EXEMPTION q
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 16 NGAGSubehapter.-7K..02.0 _
Applicant Name J' cif -ef
Address Lip, rya f r
City _/;r,;;, .se
Project Location (County, State Road, Water Body, etc.)
I ype ana uimensions of vroject
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 for;,W days from the date of issuance. Following expiration,
quirement pursuant to-15 WBAG 7K--O' "J"3. 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.
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Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assvmpjion that the
development is exempted, will bg iq viotation of t#te:CAMA if there
is a subsequent determinatic irtyi hit a permit was required,forithe
development. MAR 2 1 1997 + I
The applicant certifies by si this exemption that 1 ap-
plicant has read and will ab' mp-
tion, and (2) a written statemoa&4"baenal;taiAP- aft ent
landowners certifying that they have no objections to the
proposed work.
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Applicant's signature
LAMA Official's signature
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is#nd Ofite
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cI `lry 11
Expiration date
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Attachment: 15 North Carolina•AdrninistxatWe Code•7K--0--M