General Permits (4036)

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CERTIFICATION OF EXEMPTI
FROM REQUIRING A CAMA PERMIT
JUN 1
as authorized by the State of North Carolina, .i-
Department of Environment, Health, and Natural Resources and the Coastal Resourcesom....__._..
in an area of environmental concern pursuant to 1;5=NGAC`gubcffapter=7k«1203------------------------
Applicant Name, �J "i\ ,c\r tip, Phone Number°ikc,, •-)IA-)
Address 0­� 11crX (oo
City ­-, �1, ,'„ State Nl-- zip, ��SU
Project Location (Count!, State Road, Water Body, etc.) +tee v G a c r•-
Type and Dimensions of Project `�• <� . r �c-..� t-'\t:`s� = ' 1y o.`� , -� �>
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to re-
f This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
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.
This certification of exemption from requiring a CAMA permit is
valid for` a- ays from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
Applicant's signature
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15-Nemeth Carolina-Admfnlstretive C-o'de-7K .�03