General Permits (5545)

CERTIFICATION OF EXEMP VV 119%
Y- FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coast�fi�mmissi ry
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
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Address
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Proiect Location
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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 .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
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This certification of exemption from re4uiring 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: t+)o -r '•f-a >,;, '( ) J
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Any person who proce s with a development without the
sent of a CAMA official rider 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.
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CAMA Ojticial'Ignature
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Issuing date p
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203