General Permits (3726)

O
CERTIFICATION OF EXEMPTIO
FROM REQUIRING A CAMA PERMIT I!f
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Reso
in an area of environmental concern pursuant to 155-M—AC Subchapter-7K .0203.
- - ------------------
Applicant Name S Phone Number'-, . 3da
Address +�k . Z Jb G
City State Nc—. Zipa��GJro
Project Location (County, State Road, Water Body, etc.) 1) ~k� w-1 CJ A
Type and Dimensions of Project fS��
<A
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 15- NC"AC=7K:0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA permit is
valid for 90 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: N q tea )
of
t
—t ��� � � tug _•
(^ .mac• � �ab1�1. 1
ruiy j.iCiouii vvuv F/IVl..Q ..I111 C ovv VFiii,v,,. •♦w,vv•
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.
Applicant's signature
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North -Caro lina Administrative Code 7K .0203