General Permits (5516)

Applicant Name
Address_
City
Project Location
C.ERTIFICATION 0F EXEMPTION
FROM REQUIRING A CAMA PERMIT o
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 pursuaot4o4,5 NGAG-Subchapter..7K..02-03.
Phone Number °1 Q/157- !qS
unty, State Road, Water Body, etc.) /-4-5j,Y,!
Type and Dimensions of Project
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant -to 1,5-NCAG,7K-;,0203-: This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
0
State AVG- Zip .r4tr/v
/dJ ✓
This ct­tification 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.
I SKETCH !SCALE: )
/0'7 6
r.,
f � �
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.:statem.e.nt,has.be.en.obtained fromadjacent
landowners. -certifying -that theyhave.- no. objections --to -the
proposed -work.
APR 1 6 ass?
�i
CAMA Official's signature
//- 1y ( -7
Issuing date 7
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

tr' A
State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Coastal Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
Roger N. Schecter, Director
g2 C 2� rev
Dear may. &
1DEHNR
DATE: , / // , 1997
01
Attached is a Certificate of Exemption From Requiring a CAMA Permit. In order to
validate this permit, please sign all three (3) copies as indicated. Retain the yellow copy for
your files and return the blue and green signed copies to us in the enclosed, self-addressed
envelope.
Your early attention to this matter would be appreciated.
/dh
Enclosures
Sincerely,
" -//- //: -, '� / T__//
Field Representative
�ry�
Hestron Plaza 11, 151 B, Highway 24, Morehead City NC 28557 Nam ;W C An Equal Opportunity / Affirmative Action Employer
Voice 919-808-2808 FAX [phone] Courier 11-12- 09 50% recycled / 10% post -consumer paper