General Permits (5315)

CERTIFICATION OF EXEMPTIO !_
�U\ FROM REQUIRING A CAMA PERMIT '
J U N 1 9 1997
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Reso�r'���
in an area of environmental concern pursuant to'1�.Subchaptar 7K .0203. 'r
Applicant Name AS �V�i . 1_. • �� S Phone Number
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Address e\ 0 o cUWn�� 5
City 1� A-ti c,•! State Zip allll \3
Project ocatio^n (County, S to Road, Water Body, etc.) VO•. \ c. Qlk� 4`Z51% aSS
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Type and Dimensions of Project G Cat. %''>
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 1S_:NC�: tM-,G203. 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`gondap 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:
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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
c�.0 iY\,,R\C
Issuing date
Expiration date
Attach"mbnt`15.-flan'h--Carolfrta'fttrativP K--Q2-Q3