General Permits (3864)

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CERTIFICATION OF EXEMP ION
..FROM REQUIRING A CAMA PERMIT Y
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 pursuant to 15 NCAC Subchapter
p 7K .Oa203
Applicant Name h -
° Phone Number Lj�6
Address e
CityState
Pro�'Je L atiicn Counntt% State pad WatQr Body, etc.) e Zip
Type and Dimensions of Project
Pr Ext
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
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
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. vr�mri vuiciai s siynarugrd
The applicant certifies by signing this exemption that (1) the ap-
plicant has read and will abide by the conditions of this exemp- Issuing date g
tion, and (2) a written statement has been obtained from adjacent 7 — 3 landowners certifying that they have no objections to the
Proposed work. Expiration date
This certification 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.
Attachment: 15 North Carolina Administrative Code 7K .0203