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HomeMy WebLinkAboutGeneral Permits (4646)J -� CERTIFICATION OF EXEMPTION FROM REQUIRING A LAMA PERMIT C 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 Address Citv Project Location (County, State Road, Water Body, etc.) State -t-t.. 'T't �= Phone Number 1<)344(-� I Zip ='7i,( Type and Dimensions of Project _ c `;r; i. ,; a ,J -r.. �, c r ��• •t.;'; 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. SKETCH _ (SCALE:, %: r ., ,' ' .� I r^-,mac- Ala l t l�l ��:.� .7� i '�>LM.0vv - - - _ - _ - -- -- t t cx_�> 'V 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 ignature CAMA Offiicial's signatu}e Issuing date q Expiration date Attachment: 15 North Carolina Administrative Code 7K .0203 ADJACENT RIPARIAN PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to 's prcperly located at (Name f Property Owner) (Lot, Block, Road, etc.) on hU )Fus e R2 J r-r , in NZ-) i3F= C/eld(J ,.) , NC . (Waterbody) (Town andlor County) lie has described to me, as shown below, the development he is proposing at that location, and, I have no objections to his proposal. --------------------------------------------------------------------------------------------- DESCRUMON AND/OR DRAWING OF PROPOSED DEVELOPMENT: (To be filled in by individual proposing development) too �� / 4- Signature Print or Type Name r ?.J1.I ,3 Telephone Number -+ .'w•,;,Zyy,1\"•�.°yr'2y9C,f{;L'.ti�t,.:'ry!; 9A3.1'. 1/1 ,: 17'PI¢•1,' Ypiw "'4'''y„, .. /�• N0. 886 PO4APRi 199 :�196363127 FOLEY AND FELEY INC PS 01 �,tiyJ7n y5 f 5 } I i4''Y'•;, lt� i I � � ' f ' :I,li• hi ;, �. '• fl • ' 1 ' �! {� / 1''� ri tL,,,Y„ :k�A,Y« �'•',',a•'i�" �aO^;,r '?,r1'i,''� {.r'rl ,'r,�(� CI�It �Oy r�, +� �J �% \ ryI',�',,. 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