General Permits (5159)

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CERTIFICATION OF EXEMPTION`- �`',x�
FROM REQUIRING A CAMA PERMIT J U N 1 9 1997 i
as authorized by the State of North Carolina, f ,
Department of Environment, Health, and Natural Resources and the Coastal Resourge0Cp_nm ssion'__; _
in an area of environmental concern pursuant to 15 'N:CAC Subchapter 7K .0203._
Applicant Name Phone Number 91"') -+)'�� )U H
Address
City .., State zip
Project Location (County, State Road, Water Body, etc.) c 7� <
Type and Dimensions of Project :,,a;•.\ '=f tv .x %a
L
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.
."jk\ .
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: ,� ) I
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 date
Expiration date
Attachment:.15 North. Caro lina,Admin istrative,.Code 7K-:0203 -