General Permits (5052)

-Y-
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
Applicant Name Phone Number 1,C1l' Address_ 05 0.>rti SWN)
City ` g-2 1Z F- G7State N C---
Project Location (County, State Road, Water Body, etc.) ���11 o6,a s- - , In - SR t �2 4 n�tp M�� w
�ot►fi fa ('At�1t_Ic� t2iVSIR �F 2 WeSN, �r�rr��►
Type and Dimensions of Project i2E1�L,eCE i%U' ?c 5' pt x Z t,' �
The proposed project to be located and constructed as described This certification of exemption from requiring a CAMA permit is :
above is hereby certified as exempt frdm the CAMA permit re- valid for96-ems from the date of issuance. Following expiration, ` quirement . This exemption to -a re-examination of the project and project site may be necessary
CAMA permit requirements does not alleviate the necessity of to continue this certification.
your obtaining any other State, Federal, or Local authorization. .. .
/mac E %,>3 T r,
SKETCH
.i =Y (SCALE: N014 E )
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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 I Applicant's signature
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the 1. -i �� %A,
development. CA vlApf ciai s at
The applicant certifies by signing this exemption that (1) the ap-
plicant has read and will abide by the conditions of this exemp- Issuing date
tion, and (2) a written statement has been obtained from adjacent ,3 I Ju t✓Y 19.97
landowners certifying that they have no objections to the Expiration date
Proposed work.
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