General Permits (5591)

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 Resources Commission
in an area of environmental concern pursuant to-45-PfCA ertbchapter'=Ttf"203.
Applicant Name -7yolp �c' c�7� Phone Number""`'
Address
City State WL Zip;a-)
Project Location (County, State Road, Water Body, etc.) "hc G; . eW tk!Eu�� La�.
Type and Dimensions of Proct
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
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.
This certification of exemption from requiring a CAMA permit is
valid for-9GVays from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
_Applicant's si nature
CAIVCA Official's signature
j (140 --) L1\0 \qC I
Issuing date
,_�l C7C: i� ��, 190q
Expiration date
�4�t3c�`" t iSlTor�Th aroTina �4dminist`rafive CbZie 71< .0203