General Permits (5226)

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CERTIRCAT10M O.F 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 tc3�-#s-NC-AG-Subchapter-7K.a203.
Applicant Name ae ��°s4✓f�'1//AJ/ Phone Number
Address
City f State 0(r Zip •' (60
Project Location (County, State Road, Water Body, etc.) �� .5 % i✓».'xJY 4-
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i ype ana uimensions or rroject
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement-pursuant•to 45 NCAC-7K.,0209. This exemption to
CAMA permit requirements does not alleviate the necessity of
This°certification of -'exemption from requiring a CAMA permit is
valid for--90 days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
your obtaining any other State, Federal, or Local authorization.
I_SKETCH (SCALE:
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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.
Applicant's signature
CAMA Official's signature
/l:^ /l J.
Issuing'date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203