General Permits (5698)

-�r- 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 pu_ uantiny5 N_QAUubchap er2l<_02-03
Applicant Name X ��Pp�s,- /YJ�Phone Number
Address
City �.�r ��!�F i State ,-c Zip a 7e •�,,
Project Location (County, State Road, Water Body, etc.) L/^s7r�r� iT ra Sri i�U� s7i�i
!Ll 6/ P /// F IN/ I'Ff i . J �5 .� />.�I /✓ �F r /i<'�,.�,Y , .J /��r
Type and Dimensions of Project f ���„� /,� �, ,�nr r A- r
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pufGuant-to��ff� 03. 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 for9Uays 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:
i
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.
irelrl,G
fC�n.ArCt i �
C�
Hppli n s signature,/
CAMA.OffXial's signature
Issuing date
Expiration date
-Attachment:-45-Iorfh-Garoliaa.AdmirvsS_Eative-Ccde-7K :0203