General Permits (3969)

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-� CERTIFICATION 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 puf-sijaaj=p"-f.�a
Applicant Name ��o,�r��G �', D ��1
Phone Number A.96 c/y'f'Zj
Address ,91
City /7,4 i7i State .c/C' Zip a
Project Location (County, State Road, Water Body, etc.) ?�d6,.Co2/9-r „ reZ
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Type and Dimensions of Project—r�,r�,.r „,oi X", -757el
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement p4irstjgRtdyg_ 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 9eata;ts from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
ISKETCH
(SCALE: k I r<ki r— )
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.
LPG Ace I
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%� o�SS � J f
Applicant's signatur ff /
CYA,Off;6al's sigoaf� -1
Issuing date'
Expiration date '
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