General Permits (5799)

CERTIFICATION OF EXEMPT
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0
Applicant Name Ff r I iN4 r 3u ty\ evte- r i
Address n' r;
City Pa to yt k
Project Location (County,_ State Road, Water Body, etc.)
State
'N
1 4 997
Phone Number 9 191 761' W�
Zip CP /7
Type and Dimensions of Protect A+ .r" fq c k✓ rcy 1A « inr, d ,H' -r 4 e tr` ' c k, e jr - n, it
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 NCAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This c(-rtification of exemption from requiring a CAMA permit is
valid for 90 days 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: Mr j )
A C ,
i Lo _
C 3010
Any person who proceeds with a development without the con- " I
sent of a CAMA official under the mistaken assumption that the Applicant's signature!
development is exempted, will be in violation of the CAMA if there v
is a subsequent determination that a permit was required for the
development. 07fficial's signature
The applicant certifies by signing this exemption that (1) the ap- "' Issuing date r
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.
Ct
Expiration date ^�
Attachment: 15 North Carolina Administrative Code 7K .0203