General Permits (5648)

Applicant Na
Address
City
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CERTIFICATION OF EXEMPTIOU-.:
FROM REQUIRING A CAMA PERMIT
JUL 0 8 1997 ;i
as authorized by the State of North Carolina, u
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Department of Environment, Health, and Natural Resources and the Coastal Res isstott=
in an area of environmental concern pursuant to 15 NCAC Subchapter-7-K .0.20&—...------------
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n (County, State Road, Water Body, etc.)
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Type ayd Dimensions of Project .-4) 4 c O/.�- ,, #,,A ex 1,0 ! 4 P4 % I.5-' � " e, ) A 4 f' J0 I'e-�
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to­1.5-NCA0-7K-.02a3. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA permit is
valid farr90-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:
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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 from adjacent
landowners certifying that they have no objections to the
proposed work.
Applicant's signature
AMA Offjcial's signature
�j, ,4
Issuing Pte
Expiratibn date 'f ` -' ` °
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