General Permits (5650)

O
CERTIFICATION OF EXEMPTION�?.�
FROM REQUIRING A CAMA PERMIT JUN 1 9 1997
as authorized by the State of North Carolina, '
Department of Environment, Health, and Natural Resources and the Coastal Resources C,sion
in an area of enviirroonnmenttaal concern pursuant to 15-NCAC--Subehapter-74Er:0203____
Applicant Name I�C,�,. G _N� . Phone Number ` V-� dd� 0 (K)
Address Lc- s � ,-
City �.�- \ State Mc- Zip a7>aOn
Project yL�ocation (County, State Road, Water Body, etc.) • - ay A Ca
-
Type and D enrs of Project `_)N-uT1"-
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 1tz-ftG'AC-7.41(-.M3. 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 for9eAays from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
I SKETCH (SCALE: I
\,A
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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.
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Applicant's signature f
CAMA Official's signature
Issuing date
�•,'�. ` wit` Y` I: l
Expiration date
Attachmcrrt�t4S-Nortb-Gare4na-Administratvg-C> otle7K-.0203