General Permits (4144)

�un��lcnr.lE �r�l 5-
-Y-
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 pursu�Aun i-a�r "3.
Applicant Name PiR tom. I x 1 Phone Number n 2/%S - Gc1
Address�I
City _1 1 Z\- lz� f� I r,l/-� �? State N I C Zip
Project Location (County, State Road, Water Body, etc.)��_ r-
I'-I P \/t l
I ype ana ulmenslons of Project pk L,,r IE+ -2,S G , ,� 7 f
Z- t11., e -:Z' ,.,icy M.t__ - - - -
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement 243 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 forSG=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: I I G )
±�;!p'
_-T H G
it
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.
U,
A _.
t ;v'
--- 1250
I;c P \, 2
riCi I 1 SIG _
Applicant's signattfre
�CA�v1A ©i�ic"ial's,s�nature - i � �~
Issuing date
Expiration date
Attachment°- �-Codc::7203