General Permits (4584)

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 pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name
6w4, �. j',�A f' ` Phone Number
i'S c1 / �6 2v
Address
171 J<«Ta f
City
i , State L/1 i
Zip s;
Project Location (County,
State Road, Water Body, etc.) I ? i =;c. A Ct c. (; !
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Type and Dimensions of Project I<(_ inr,
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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.
I; fl4i-i
0.
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. tf<.
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Any person wTio proceeds with a development without the con-
sent of a LAMA 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.
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Applicant's signature
CAMA Officials signature
Issuing date
Expiration date
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14,�j, �.
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Attachment: 15 North Carolina Administrative Code 7K .0203

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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 pursuant to 15 NCAC Subchapter 7K .0203. F-+< t&�;( - ZC-Z-1
Applicant Name lr Phone Number 2S7 36 2-
Address—
City / — State 7,zip
Project Location (County, tate Road, Water Body, etc.) tZ j c ![L 1p 14 4rES.
Type and Dimensions of Project t�> J 6 t rZ /fir S b4-, i (- t? L, / 1, —
A-1 , r-' A 1AA e Iq. v1 "- --4,
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 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. /, y1l�')
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Any persoh w o ro ds witr Mevelopment without the con-
sent of a gAMA official under the mistaken assumption that the
developm nt is exempted, will be in violation of the CAMA if there
s a subseuent determination that a permit was required for the
velopm Int.
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 Of'riciafL signature
Issuing dates`
�✓ • 2-7 1 Jq q
Expirati n date
Attachment: 15 North Carolina Administrative Code 7K .0203

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North Carolina Division of Coastal Management
1367 US 17 South
Elizabeth City, North Carolina 27909
Phone #: [phone]
Fax -: [phone]
TO:
FROM: M6-"S
DATE:
RE:
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