General Permits (5824)

CERTIFICATION OF EXEMPTI(
_Y
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal R
in an area of environmental concern pursuant to i6:NGAC Subl hapter 7K_..02C
APR 1 d 1997 111
Applicant Name c-� Phone Number 4;\R •
Address'��.,
City State
Project Location (County, State Road, Water Body,
Type and Dimensions of Project :. �•� `� s 4 w , �,,, _ �,1.,aC�,�Y.
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to-11-FrIIGAC MX203. 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 for'90"�ftys 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
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.
s signature
CAMA Official's signature
Q � tf' P1L. \W)
Issuing dat*
Expiration date
Attachment: 15 North Carolina Admr ihistrativb-Code 7K .0203