General Permits (3729)

CERTIFICATION OF EXEMPTION ,
FROM REQUIRING A CAMA PERMIT JUL d 8 1991
as authorized by the State of North Carolina, 1r s
---
Department of Environment, Health, and Natural Resources and the Coastal Res '"
aCrtilssio'ai ' f^>1
in an area of environmental concern pursuant to 15-NCAC Subchapter 7K .0203.
Applicant Name a��'� i`�4 C.� Phone Number ' ' - V1,
Address ':.w. t' QN
City ``' , State -4-- Zir) t J
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project _ _ - < Y r E
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--NCAC 7K-...0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
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.
This certification of exemption from requiring a CAMA permit is
valid forgo-daysfrom the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
Appp l icant's. sig n at ure
CAMA Official's signature
Issuing date
Expiration date
Attachment-:-15 North Carolina Administrative Code 7K .0203

Applicant
Address -
City
Project lFc
CERTIFICATION OF EXEMPTI
DPP{mil
t.-..
FED 0 :997
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, y
Department of Environment, Health, and Natural Resources and the Coastal Resou�`r�� `l'`,'Mft%"C"0_%*A*WVA r.
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
!t1kv*-, )?`2�te'f) Ik/"A-YAe �%�iA0r Phone Number
1. c State . C, . zip ' ..7rK
Aunty, State Road, Water Body, etc.) �.,� :� ` ti - —
Type and Dimensrnns^ f Project Ar a r
J�y«
� 1
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 NCAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
C�.
A< • - t t ra
2
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 c (SCALE: a, )
wJJf=�>
a- : , �,►�s8�
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.
;,
Applicant's ignature �{.►— !
CAMA Official's signature
I- /j
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203