General Permits (5277)

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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 ResourceiCommission
in an area of environmental concern pursuant to fiS�VC:AE17t3�f303
Applicant NameUe. �� ��1��� Phone Number q\O\
Address _�,\ 1��%� xc r 1� Ct: c,c 1. t;�c•�
City it - r State N Zi �1ci-) 0
Project Location (County, State Road, W ter Body, etc.) \N 41�,���.� C_"' '->CZ. iv,U�. 11,>,XIA4,
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Type and Dimensions of Project vcN t JG� c�cn
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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-.020& 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
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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"� signaturo
CAMA Officia g�n'l`
Issuing date
;.Y �Gq�
Expiration date
Attachment t5--Na tL0arolina.Admin.iswMve-Coda,7K:.0203