General Permits (5071)

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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 1-5--NCG G-Stjbehapter-7#E-fl203.
Applicant Name 1-_& . \ "A Phone Number%CA • boV� -
Address 0 %j t^% c�d(o
City State �L zip sb 3
Project Location (County, State Road, Water Body, etc.) eU.� C,1. c,�C `�R \ f 5v;,n
Type and Dimensions of Project �% f (1c,
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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 15.1-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 for90:days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
I SKETCH (SCALE: tUGiv' ) I
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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.
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\ucant's signature
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CAMA Official's signature
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Issuing date
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Expiration date
Attachmen -15 No4h•Garoffna-Admirri5t7a-fi -Code-7-K.: 203