General Permits (5742)

CERTFI-CATION-Q-E EXEMPTION
_Y 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 purl,uanLto-.1.5-NCAG-Subehapte 7K-:-@243.
Applicant Name
Address AK 9!
City !::�k�.sjo.W
Project Location (County, State
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 pursuant-to=15...NOAC=744�LIO3. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
12,11, -/Z 1 /
.PS
SS4s- 4,,
This c(rptl
on of�emption from requiring a CAMA permit is
9 valid for.04aysMm 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: )
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 "6tni4ot-,has been.obtained i m.ad:jacent-
landowners.-certifying- tfiat-.they, have no-=-objections-«4o--th9
proposed--,work.
Applicant's signature
f/ I—
CAMA Official's signature
Issuing date
?-31- C)7
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203