General Permits (5127)

C E R-T IF I=GAT-11 N -0*E 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-pursuant4o-15.,UGa AC-Stib-6Tapter7K--G203.
Applicant Name r),(Phone Number ?V3— C& 2.
Address
City NltnJhor /
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project
Y f 1) 10 ')
r L f
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.
o — State
;�'g 1- 20
This cent xemption from requiring a CAMA permit is
valid f&,ie8 :ays 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 ,J (SCALE: A/o A.k )
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a,cr--
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. hasheen ebtained#rom adjacent
landowners certifying that they- have -no objections to tfte
propgse1work.
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Applicant's signature
CAMA Official's signature
////A6
Issuing date
r/3/AI - -
Expiretion'date
Attachment: 15 North Carolina Administrative Code 7K .0203