General Permits (4346)

Applicant Name
Address
City 41.
Project Location
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CERTIFI-CATI.ON OF EXE
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and
in an area of environmental concern pumtFar Vte-+5-N@A"- rbel
t, State Road, Water
Type and Dimensions of Project
Ie
State
l
etc.)
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The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA.permit re-
quirement•-pursuant-te-l-&-INGA'O•7K-10243. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
SEP 1 9 *%
Phone Number
Zip
This c9zfficatkrrrT)f e—kemption from requiring a CAMA permit is
valid for go -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: ;, )
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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 (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 4he
proposed•work.
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Appucant's_signature_,
CAMA Official's signature
3' 9
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

State of North Carolina IT
Department of Environment, LTR;qAl
Health and Natural Resources 4 •
Division of Coastal Management
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James B. Hunt, Jr., Governor p LE H N R
Jonathan B. Howes, Secretary
Roger N. Schecter, Director
DATE: 1996
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3 4/S3
Dear _'4 cf�nr
Attached is a Certificate of Exemption From Requiring a CAMA Permit. In order to
validate this permit, please sign all three (3) copies as indicated. Retain the yellow copy aad
for your files and return the blue and green signed copies to
us in the enclosed, self-addressed envelope.
Your early attention to this matter would be appreciated.
Sincerely,
lew �� —
Field Representative
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Enclosures
P.O. Box 769, 3441 Arendell St., Morehead City, North Carolina 28557 Courier #11-12-09
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