General Permits (4350)

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liltCERTIflAT-IO -OF EXEMPTION C�
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 purst4aftt-to-1.5,,NC'AC-S-ubchapter•7K-:0203.
Applicant Name / ,11—"/C! Ale, .r?[ r Phone Number �� ` rid:- sit
Address l�r; l�' , /i
City A: � F -, A ._11 State Zip ,.7 2( 1 �
Project Location (County, State Road, Water Body, etc.) /r%•� � ��, '� : �s . /c. % �i�
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Type and Dimensions of Project ,�.:,-, _- 1 ,/ � ` A, a ' ,` .-f _3'cY' C " -
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The proposed project to be located and constructed as described This ce Uf.ic-ation-of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit re -,valid for-g&days from the date of issuance. Following expiration,
quirement pursuant -to -15 NCAG 7K .0203. This exemption to a re-examination of the project and project site may be necessary
CAMA permit requirements does not alleviate the necessity of to continue this certification.
your obtaining any other State, Federal, or Local authorization.
I SKETCH (SCALE: 4 ) 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 (1) the ap-
plicant has read and will abide by the conditions of this exemp-
tion, and (2) a written statement has beenobtainedfrom-adjacent
landowners. ..certifying --that they have -no objections -to -the
proposed work.
CAMA Official's signatur .- �-
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(r' Fr% e% -16 -1 0 4 n r�c
Issuing date ;! -
Expiration date rlfNwristir+�a�,raazm�a��ii'�i�N
Attachment: 15 North Carolina Administrative Code 7K .0203

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Coastal Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Roger N, Schecter, Director
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it/�cJ /�.�•�� �t/c Z�f6�
Alk"14. TA
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�EHNR
DATE: �V, / / , 1996
�-" d,-. 6 am' './a ids .
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 and
the attached regulation (7K .0203) 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,
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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