General Permits (4348)

CERTIFICATION OF htftlEXEMPTION�1
-Y-
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, 1
Department of Environment, Health, and Natural Resources and the Coastal Re s Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K`.020 .
Applicant Name r ,. I t. t lid-t<.1 Phone Number L7_;:6
Address Z /yLt'a E,=/ 'cL ',_��t} ; ;•;
City State Zip
Project Location (County, State Road`, Water Body, etc.)
J j i k4 A.i 1 4
Type and Dimensions of Project tt e
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.
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A4 r"
This certification of exemption from requiring a CAMA permit is
valid for 90 days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
development is exempted, will be in violation of the CAMA if there J "1-f- '
is a subsequent determination that a permit was required for the
CAMA Official's signature
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.
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

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