General Permits (3783)

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...CE-.;R-T-----l-FI-C-ArT-I,ON70F EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
f Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
r� in an area of environmental concern pursuantto 115-'NCAf-Subchapter 7K .0203"
Applicant Name `7,/. �? Phone Number
Address 9-1 ,7,4//
City 1'1.. ,_,t '• State zip�L'S
Project Location (County, State Road, Water Body, etc.) ¢r% /,,r�; r.:., !. r:/,,�., yF,T
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 pursuant to15•NCAC-7K­.D203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
. t%re
ISKETCH
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This certification of exemption from requiring a CAMA permit is
valid for-Wdays from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
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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.
i ', 1
Applicant's signatu
CAMA Official's signs re
i
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203