General Permits (4533)

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CERTIFICATION OF EXEMPTION
JUL 1 5 1997 f
FROM REQUIRING A CAMA PERMIT f,
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as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resourcen-0—nmrrsst=-----
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name A
Address 14
City A
Project Location (Coun
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State Road, Water Body, etc.) lift Aff
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State
Phone Number 10,5 — 0 69 , C
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Zip ..9 0 0
Type and Dimensions of Project ____.. f-! 5 A cirn c.,42 o zoi7 7ru 6 s P.5 r4dV 7-
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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 NCAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This c(-rtification 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.
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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.
signatu
CAMA Official's signature
Issuing date
Expiration date
6 "Iq 6.
PAMA4
Attachment: 15 North Carolina Administrative Code 7K .0203