General Permits (4359)

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 #5-MAC-Subchapter 7K .0203.
Applicant Name Phone Number )71'7- YdG` 0/ �
Address e & lGn�/t1L 2i
City State zip Est/
Project Location (County, State Road, Water Body, etc.) rNFG�I ��6�,✓7 _-.r/ �f =< f 7l;
Type and Dimensions of Project 6T lJss %� %14s �x'STiiy� y �l- _f�.�� �I, ;.: i %?y
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 1,5-NGAC 7K .0203:-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 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 (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.
Applicant's signatu.e j
CAMA Official's sign�tbre Q
t.-t
Issuing date
Expiration date
Attachment:' Ib-North•Gafbiina.Administr ve-Cod€-7K.0203