General Permits (3863)

CERTIFICATION; OF
FROM REQUIRING A CAMA PE IT
as authorized by the State of North Carolina, ! SEP 2 0 19% (d�
Department of Environment, Health, and Natural Res es and t_he,oas#�a R s Commission
er in an area of environmental concern ps"n1 to-,l 't '
Applicant Name GeJI..l1• � ' Phone Number s Z-5C ~ t ./9
Address t0'G,
City - ? <; �•f,.., _ State V14 ZiP4,1�,� �
Project Location (County, State Road, Water Body, etc.)
i7 f 'llp ram, . � (,i/�t'-it. !ji/es.r„�•�• /::'�-e.P �, L�'i : � �-t5:n[" f � �` A�
Type and Dimensions of Projekill
The proposed project to be located and constructed as described This certification -of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit re- valid for•90•days from the date of issuance. Following expiration,
quirement pursuant,4*45-• VEA4°7,K--0203. This exemption to a re-examination of the project and project site may be necessary
CAMA permit requirements does not alleviate the necessity of to continue this certification.
your obtaining any other State, Federal, or Local authorization.
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I SKETCH $ (SCALE: 'Z - ) I
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r % c1f k �-• r ��'.�-r'?h� r. G''e'1-,�,6`ticul
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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 obtained4rom adjacent
landowners --certifying >that they have no -objections - td'the -
proposed work.
Applicant's signature
CAMA Official's sign re
9`r-?- ^a6
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

State of North Carolina
Department of Environment,
Health and Natural Resources 4 •
Division of Coastal Management
James B. Hunt, Jr., Governor y p E
Jonathan B. Howes, Secretor
Roger N. Schecter, Director
DATE: & / /3 1996
f6 uoso� IAA 23CCZ
Dear
Attached is a Certificate of Exemption From Requiring a CAMA Permit. In order to
validate this permit, please sign all three (3) copies as indicated. Retain the yellow copy .nd
he attaeh ) for your files and return the blue and green signed copies to
us in the enclosed, self-addressed envelope.
Your early attention to this matter would be appreciated.
Sincerely,
Field Representative
/dh
Enclosures
P.O. Box 769, 3441 Arendell St., Morehead City, North Carolina 28557 Courier #11-12-09
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