General Permits (3851)

TI TEXEMPTION
CER FICA ION OF
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, Q�
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission i
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant N me 8er f I _0 -f Phone Number `' - 792Jk, ' % P S-
Address V C .
City Lity, rj^- a -I-. el Mate F Zip _ 3 J
Project Location (County, State Road, Water Body, etc.) C r, `7 r
Type and Dimensions of Project 1,4 d ,,� l Kl, -tea
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
LAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This c(-rtification 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 (' &� `t 4 (SCALE: ) ,
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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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Nw,
CAMA Official's signature d%
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203