General Permits (3849)

CA,1J FRo-J
CERTIFICATION OF EXEMPTION
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
Applicant Name _ M11c �: u Phone Number /919��4� - ( 'Coe)Address G 3 R F t3A, / c f D� D -
City OCICUIsIILJ1-rV State- Zip 27,:9i7
Project Location (County, State Road, Water Body, etc.) �3FA „C-nP_
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Type and Dimensions of Project do k I S' x D ' i-)�=cK
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement GAEr7i4­0203. 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 Stems 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.
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Applicant's signature
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,MA,01jhcialXs ignature
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Issuing date
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Expiration date
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