General Permits (4029)

JI % t d /i n INS
CERTIFICATION OF EXEMPTIOW'�^����
FROM REQUIRING A CAMA PERMIT I JUL ® 81997 '
as authorized by the State of North Carolina, .�
Department of Environment, Health, and Natural Resources and the Coastal Resour �ssibn- : '
in an area of environmental concern pumuant'ta 1`5-NCAC'Sub-chapter 71<C .02a3----- ---------
Applicant Name
Address /
City
Proiect Location
Type and.Dimensions of Project
r' m) A CA a i e_ �-- roe./ i bock, 1,,A
The';roposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursaarirto`l"CAG7K':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-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.
SKETCH (SCALE: /�'a� )
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a i r a - - -- �--—
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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 statement has been obtained from adjacent
landowners certifying that they have no objections to the
proposed work.
Applicant's signature
VAMA cat iars signature
,s
Issuin dat,6^
r-7'3 °I
Expiration date`
Attachment,, 5-NorthEaro4ina Administrative-C60ep71K-:0203