General Permits (5787)

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 pursuant to T&UCAC-Subchapter 7f MG31. �}b - %7) (k{)
Applicant Name G(C� )\Y*.. o" r • Phone Number �1\� • ���- ��`> �C�J
Address cmrNe_r'y\
City State Nay.. Zip a-1
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project
\ N�
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 1S:NCAC=7X< 0203. 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 forg0,,days 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
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.
icant's signature
CAMA Official's signature 0
Issuing date
Expiration date
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