General Permits (5592)

-Y-
CERTtI I ATION-=- F EXEMPTION
FROM REQUIRING A CAMA PERMIT rB1'
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 pdf►ar4Wo-15 NCAC Subch9Pt0r,7-K .420,3.
Applicant Name rs �%�r f`:.� Phone Number
Address '7>1elp t3aX ?0?
City b_~ 4e_ State Al C Zip
Project Location (County, State Road, Water Body, etc.) � �h/:� . c . r oy' al'ale,/
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 pu;euant-to46-NGAG-.7t�..020&.—This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
Thi§.,crtTiication of exemption from requiring a CAMA permit is
valid for ysfrom the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
iA r;
SKETCH (SCALE: )
A/Jt
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 4-rem-adjacent
landowners certifying 7that they -have- -ncF objection-&Ao__the
proposed work.
j _ A:,I
Applicant'ssf'gnature
CAMA Official's sigrfature
,r- ? i C,
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203