General Permits (5730)

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C-E IRTIFI AT-1-ON 10.F 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 pufwdaf44e-*-NOA-&Subchaptefwz"203.
Applicant Name ��'lF .'�"� Phone Number
Address
City
Project Location (County, State Road,
"L-,1 1i616r/ r&i t
Type and Dimensions of Project
State
etc.)
a r i
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement-pur6o,a tt-IU*' 5='N'CAG-7*^OM3. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
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This-eertification-of exemption from requiring a CAMA permit is
valid f6r,90,6ays 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
Y
�dldre % .dl i��vr9�E�.
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 frbm-adj�cant
landowners certifying that. they knave "no objections to the
proposed work.
i
Apollir/ant's 'signature
C/ r i
�1 G
CAMA Official's signiature
1-/�/-t/6
Issuing date
5- ?_J 1'7
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203