General Permits (4536)

O
CERTIFICATION
OF EXEMPTION
i
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, J U L o 8 1997 `' 1
Department of Environment, Health, and Natural Resources and the Coastal Resource `°; mmission. ;,..
in an area of environmental concern pursuant to 15=NCAC St7bthapter-7K 0203. Lt-- ja Lf
Applicant Name v' , "2 ;� . iriG,l : r� c , Phone Number ci\"� • +"�►`S - 5�
Address 'ti J + 8 U
City State OZ,t Zip t i
Project Location (County, State Road Water Body, etc.) 13L:L . L C-1ik V)L! i, '5 �J�_ IN
, -
Type and Dimensions of Project T_AC m.a �a�^ aX 1
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 1_5-N0AC'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 for9G-#ays 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: )
1
t
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.
Applicant's signature
CAMA Official's signature
Issuing date
Expiration date
Attachment7-145-'North Carolina Administrative Cotit-7K.0203-