General Permits (3920)

CERTT-, .;- ON OF EXEMPTION
_Y FROM REQUIRING A CAMA PERMIT p
as authorized by the State of North Carolina, rd/
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pur-suantto-l5_-NC-AC-S-wbetraptsr7-K-,G2�O3..
Applicant Name
Address A
City
Project Location (County,
load, Water Body, etc.)
State
Phone Number
Zip 7 f rs 7
Type and Dimensions of Project v• o•� ; ,r (G _
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-.NEAO-7*42--09-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 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.
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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-statementfias beenoWained frem-adjacenth
landd�irr-ters' certifyarag that. they--have_r1Q -objections W—the
propo.sed.w,Grk:
Applicantrs`signature /
CAMA Official's signal e
,)- e 9 - �6 read
Issuing date
3 /- CW
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203