General Permits (3981)

CERTIFICATION OF EXEMPTION
_Y FROM REQUIRING A CAMA PERMIT FEB 0 197
as authorized by the State of North Carolina,'
Department of Environment, Health, and Natural Resources and the Coastal Resour fission
in an area of environmental concern parsll=to-lb't4CAC=-SUbchapter74<--.0203.
Applicant Name /f/r�•�d S �'� r ?'ca�v r Phone Number
Address _/ / .0a� 3 7,4C'
City �' State NG Zip 7J-uf
Project Location (County, State Road, Water Body, etc.)
r <v A/e- rA?
Type and Dimensions of Project elr,r- e _?su ',,v S
_i /., "X/G •�1F-�7r :'IAI: �7 -'G '.>- '?o .v >> � ' .D o c re
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.
This certification of exemption from requiring a CAMA permit is
valid for 9&deys from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
SKETCH (SCALE:
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.
i
Applicant's signature
C,1 A ffi ial's 9ign6tu
Issuing date
Expiration date
Attachment-15-North=Ga a -9263