General Permits (3901)

CEF-TI-FICAT-I'OVN."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..pu.rsuant-tca-ib-Nj&A&-S'ubch'apter 71( .0203.
Applicant Name r • /4 re, / , 64. %Q Phone Number /,?/�; �.��• t'a �'i
Address 1312 2r
City State rt1C. zip ZSS6�q
Project Location (County, State Road, Water Body, etc.) o . 6;
i = /J
,'.lam-J•"!G-�I-�iS.J�re o
Type and Dimensions of Project k % ; -,r : , f
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursua to a'5-NGAQ-7K-t0203 This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This c�-rtl catioh of exemption from requiring a CAMA permit is
valid fofi,904ays from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
I SKETCH (SCALE: , �.�) I
A16, -714
0 o
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 obtainod-from adjacent
landowners certifying ..that --they Kave--no .objections,--to--.tKe
proposed work...
Appli n 's signature 1(.�
CAMA Official's signdture
.�
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203