General Permits (4233)

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CERTIFICATION OF EXEMPTI M�
_Y FROM REQUIRING A LAMA PERMIT �}1 �
as authorized by the State of North Carolina, ? SUM 1 9 1997 11
Department of Environment, Health, and Natural Resources and the Coastal Re _fps.Commission
in an area of environmental concern pursuant to tSaAC Sabcfrapter 7K"" Q2Q �
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Applicant Name Phone Number:*--1 S '
Address
City y.: oU—. State zip
Project Location (County, State Road, Water Body, etc.) \ �_ rnv,. ��► �.' �� C% +�. \i•. ,
Type and, Dimensions of Project Lk `3 c.
+'CA , V\ - ^' - W
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 J043, 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'9045ys 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 (SCALE: u;,r" ) I
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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 (t) 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.
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Issuing date
Expiration date
Attachment�-1,5 Northri�-,arttffna7Adminietrative-Code 7K':0203