General Permits (3850)

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CERTIFICATION--10F EXEMPTION
�r 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-pursuaateAS NME S-abcKapter-•7K-.0203.
Applicant Name Phone Number
Address r :2.2 .!c,ce . .J,r .
City j _:F i State /L/C. zip ��'► y
Project Location (County, State Road, Water Body, etc.) �j,- 777 r.
Type and Dimensions of Project `; id ' le 9 47r
y
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-NOAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This certifieatieni f exemption from requiring a CAMA permit is
valid for-90, ays 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.-
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203