General Permits (4507)

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CERTIFICATION OF EXEMPTi®:"
FROM REQUIRING A CAMA PERMIT FEB 2 o 19979
:
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal R
in an area of environmental concern pursuant to 1"CAC Subchapter 7K-.0203,�606041 �� .
Applicant Name 4' J;:;) c �, � - Phone Number %cN-;yV'Yl - v`ti V-)
Address-'\
City ? .. il'tic �F. State iV�.. Zip 4-)10H
Project Location (County, State Road, Water Body, etc.) j'.ov ,r� :A. �l : U ca a 0,.,�.\�-
-, c cr.-• 1���C��y e.....
Type and Dimensions of Project ����c. `' ��•a c -
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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 pursuant to 15- NEAC 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: Nt QNN�_7- )
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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.
Apllcant's signature
CAMA Official's signature
Issuing date
\C�Ck1
Expiration date
Attachment: 15-NorthCarolina Administtrativd'C6d`e7K -.0203