General Permits (5084)

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C E�RTI= _40N.0,F EXEMPTION 9,,�A
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-to1-5-Pd-GA& Subehrapter 7K .0203.
Applicant Name /'Vn:?
Address 6Q 38
City _ r:zTt
Project Location (County, State Road, Water Body, etc.)
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-1h5 NGAC_7K-:0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
Phone Number
State /v G
5
Zip ?b.r 7/
cation of exemption from requiring a CAMA permit is This certifi
valid for-904ays from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
C"- eeJ,\PiiV c S
j SKETCH /i (SCALE:
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 obtainedfrom adjacent
landowners certifying that -they have no--objections--to- -the -.
proposed -work.
i
24, f.
Applicant's s�nature
CAMA Official's signature
? - /!- �7
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203