General Permits (5211)

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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
Applicant Name I; ra ,At t� Nbc n-n �j Phone Number (R 13� ('fir S - U J��)
Address 8 Ox o,-) 5 3
City I n (�t=oc +-t State r4 r t Zip 37 _c -7_
Project Location (County, State Road, Water Body, etc.) c.pirz e� r s>? , -7.2 f �T
PIt.11 rsG!Pic A)F4!a. rn ry
Type and Dimensions of Project } 3 �c ' :,o, �s �� �n mac, - n 9,/
a41'f21c�J� o.J0 P, 4C n ,or '0 'g-VL.oc1:
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement }aucsuaat #� '�;^-�93. 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 fors from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
V
SKETCH I (SCALE: i\6'I s ) 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.
IX
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J,
s signature
CAMA 9ffigia!'s gIgrratu e /
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Issuing date
E� I T__o -/ I G�-7
Expiration date
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