General Permits (3918)

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CE-RTIFIC T 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•pumuant44D-4-5.NGAAB'-S6ibchapter 7K -.0203
Applicant Name � ri,l, � �� Phone Number 1%10.35 3- 7(/' 21
Address /f, t' .
City State Al G zip . �J r6 Y
Project Location (County, State Road, Water Body, etc.) v 70. V /
1' " Z t -1v1 i to rd
Type and Dimension of Project /r r 114-rC 1 y' nip
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement purest-_fo_ �5-.NCAG-7-1C-0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA permit is
valid for_9O-bays 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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SKETCH (SCALE:
f�Ie f,r f it e('CrAJ Al" L 10- S0 1-Y V I
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.
,��plicant's signature
LAMA Official's sigrature
' - - 9G
Issuing date
'Y- 3i- 9 7
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203