General Permits (5235)

r
_C E RTI:F4C�T-10-t,-�t- EXEMPTION
-� Cif
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-ter-1-5•NGA63,6-ubehapter-71K-.0.24a-
Applicant Name 14� .. 0_/"'X. Phone Number 7284 S-f-I
Address _ / S S "s l fofry
City State �/ / zip // 9s/F
Project Location (. ounty, Stat Road, Water Body, etc.) s,1
Type and Dimensions of Projjct�e��
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-NeAC7K-.02&3 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 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.
SKETCH (SCALE: )
l ) r JY%iY �CJC� C-
f'--� //r,' •e��,.z. fib/%�R/• " ���;Y�; �,/r / L2.� /��n• % � ; ,
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-be-en.obtained-from-adjacent
landowners -certifying- that they 4Tave no objections - to -Aloe
proposed.werk.
Applicant's signatur
i
CAMA Official's signature
?-//-��
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203