General Permits (4499)

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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 p�rstia�t-to�tti'rV St�bcapteF7Z03'
Applicant Name Phone Number
Address Jj! t4rek a - 17
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City ,r t e e) )V'//F State G Zip 6
Proje t Location County, Stag Road, Water Body, etc. feo at, Z4 e913 eo VAt r
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Type and Dimensions of Project A d e i r air re 70A a X &
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The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pars0 ffl-M M—NCAC-7K-.'8203. 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.
j SKETCH (SCALE: 1 417e__ )
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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.
is -
/
signature
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Issuing date
1 �n diPi- 1 99 2
Expiration date
Attach ment:-t8 irt5MTICarotirra-Administraiive-Co' ie 7K.'0'2-0S'