General Permits (4247)

CERTIFICATION OF EXEMPTION 9
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 pursuant to 1-5=NCA,-Subchaptet.7X :0203.
Applicant Name.,=r�-• ;_+' `sue `� Phone Number ` ,
Address
City k State 0 Zip
Project Location (County, State Road, Water Body, etc.) .: ` t-,=i�.a
Type and Dimensions of Project ed tee :Jk l;a
J
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-.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 90Aays 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: NONE )
. y� . do � {. �1rc• � .� __ '
Any person who proceed ith a development without the con-
..4 :,
sent of a CAMA official u >�h t ' ptbry�rpptin"n.fhat the
development is exemptedx��gq. r�_ c,t}ie'CA_M/j• if there
is a subsequent determin t that a permit was requir Yd 16 the
development. MAR 2 1 1997
The applicant certifies by a ap-
plicant has read and will t i-xemp-
tion, and (2) a written statemen "Mil 51WRIII1"W8101.0jacent
landowners certifying that they have no objections to the
proposed work.
2. wJ
Applicant's signature
�\ C'
CAMA Official's signature
~t
ra A \� !
Issuing date
Expiration date
Attaohmcant: 15 North Carolina -Administrative Code 7K .0203