General Permits (4435)

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C'ERTIF-ICA-TI N`,-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 1.5-NEAG-Subehapter•7K-se203, i
Applicant Name 7, r,s
Address Q ,� // 75p, 2,lr,,-
City A //S NGtr <
Project Location (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 pure uant,to-5-NCAG -K -02,03. 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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Phone Number 70 �)17.1�f✓7 .r?
State A yY // Zip
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Thisoe.t kgJkxa-eMemption 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.
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SKETCH (SCALE:: „K )
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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_ _h"e_n^ oMections= -too--the •
proposed- work.
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Applicant's signature
CAMA Official's signature
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Issuing date
-3/ `1
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203