General Permits (4207)

CERTIFICATION OF EXEMPTIOW,
FROM REQUIRING A CAMA PERMIT JUN 1 9 1997
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal ResourcLUZ6_30-MU +
in an area of environmental concern pursuant to 15+1C- G Sulrchapt9r'.7K-_Q203.
Applicant Name Phone Number '^ ,'i 1"1 -.l tiy •?'�
Addresst;d 4.►,1\+�wsw- 1 r-�-
City State Nl,' Zip
Project Location (County, State Road, Water Body, etc.) i-�aout� C+� JKk `A \\--A& a 0?�',1\5
l .,M I.N-0 w C_ \ CA, kA.,
Type and Dimensions of Project ;G r ` IJ
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 1-5 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-96:days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
I SKETCH L -. - , _._3 (SCALE: 1 ,l �1 )
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.
licant' nature
9t-
CAMA Official's signature'
Issuing date
�, ' ,� i 1; i �• 1 �1y �
Expiration date
Affadtamonnt-15-Northam'n51i�Administratim-Code? "0203