General Permits (4303)

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 pursuant to'f---WsAC-Subchapter 7K-:02-03.
Applicant Name G\r\ `�OCO%0' e L •�oc�\ C� CQF 41 C nc�c,1:^� Phone NumberR6 - O W A - 0`t5a
Address
City State yyC_ Zip:0 1�
Project Location (County, State Road, Water Body, etc.) (.,. o, !sq kkatC�
Type and Dimensions of Project ����� �L - ren�4.: �. �� v- 5 '� _'ti0 4. V):'
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to15JWAC=7 C-_Q243_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"9(7nys 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: )
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.
s
Issuing date
Expiration date
Attach m� a T5-North Carofi�TaS tlministrafive Code 7K—.0203