General Permits (4856)

CERTIFICATION OF EXEMPTI , .,
FROM REQUIRING A CAMA PERMIT ? APR 9 1992
4:
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Res gg es: Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name kvP - .S c ` r r Phone Number
Address
City / rState 1/ Zip 2.3 4/_ cS
Project Location (County, State Road, Water Body, etc.) - - U-, �!c /� .
1
61
Type and Dimensions of Project
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.
SKETCH F 4J t —
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.
(SCALE: )
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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.
x
CAMA Official's signature
Issuing date
Z_
W
Expiratiopi ate V
Attachment: 15 North Carolina Administrative Code 7K .0203