General Permits (4355)

Applicant Na
Address
City r
CERTIFICATION OF E
FROM REQUIRING A CAMA PERM
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resour,
in an area of jenvironmental concern pursuant to 15 NCA
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n (County, State Road, Water Body, etc.)
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Type and Dimensions of Project
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.
DEC 1 2
st 1 Res i U mmission
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Phone Number �i� J►lI'�J
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.
SKETCH 1 f I J ,f I� i, (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 the
proposed work.
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Appl46ant'6signatur�i,�
CAMA Official's sig ature �--�
Issuing date
Expiration date I '
Attachment: 15 North Carolina Administrative Code 7K .0203
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PLOT PLAN
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for
KTHY M Co P(FFMf
SECTION._____.__--- SUS01VISION
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r�JIT0WMSHiP NEW HANOVER CO. M. C. �
SC.iL�
- JACK G. 5TCCIS
J.C. Rogistrarion No. L-956