General Permits (4957)

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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# f)/
in an area of environmental concern pursuant to 15=NOAC-5ubth6pt"er--7K":0203:
Applicant Name L i ti u rf 1,L,k j 4� t4-I - Phone Number
Address ( (a `d S C A F E L. f1 %',G
City t , rf 14 State A; C ZiP < 1 z.
Project Location (County, State Road, Water Body, etc.) c` li R tTcrc K r. CdZ%4
Type and Dimensions of Project t. rYt4t )< X1 5"T/ �i 3LfL JC /i rt 4> r �
v
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to tS-NCAO 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:�
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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.
Applicant's signature
�-
CAMA Official's signature
Issuing }} ate
Expiration date
Attachment: 15 Nc�r#i-Ga�e4a-Adrraii5#wati�re-Cede 7KK-0202.