General Permits (4467)

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CERTIFICATION. -OF EXEMPTION
FROM REQUIRING A CAMA PERMIT ��✓
as authorized by the State of North Carolina, /_14
Department of Environment, Health, and Natural Resources and the Coastal Resources Commissi n
in an area of environmental concern pursuant-to.15 NCAC Subehapter 7K.0203".
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Applicant Name , : ` // -- 'c ✓ l_n,, A,-70,
City
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project
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=J '��• Phone Number'//% 322
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.
State zip -"2jf"" 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 (SCALE: )
r
n _ .,L... ..A .4k o rin nln nt withni it tho rnn-
sent of a CAMA official under the mistaken assumption that the
development is exempted, will be in violation of the CAMA it 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-,statementh isbeen obtained from adjacent,
landowners certifying that they have no objections to the
proposed work.
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Applicant's signature
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CAMA Official's signature
9
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203