General Permits (5522)

CERTIFICATION OF
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 to 15 1NCAC Subchapter 7K .0203.
Applicant Name J�t�+ ! iG e_J u..,A c q ( 1v V J i
Address
City
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project 1 3
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 .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
development is exempted, will be 6 )[olation.of the. CAMA if there
is a subsequent determination that!a; 6' yrnit was'required for the
development.
The applicant certifies by signing t xemption that (1) the ap
plicant has read and will abide bya_ �+
tion, and (2) a written statement ha
landowners certifying that they have no objections to the
proposed work.
hone Number
_State ate'' C- Zip
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.
CAMA Official's signature
Issuing date
/-- 712
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203