General Permits (5900)

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CERTIFICATION .OF EXEMPTION
FROM REQUIRING A CAMA PERMIT._
as authorized bythe State of North Carolina,"
ODepartment of Environment; Health and Natural Resources and the Coastal Resources Commission
in an area of environmental concern �d;sflt�e f
A Iicanf Name C S M n� i
pP Phone Number
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-:•:. Address=`'7c�`.:"I��A�t-1 �;� -1\ . >-.___ ._ ......._ __ :. ,: _
City 13 F t. n �J'C—' t.! State NJC. Zip 2 1 C �
Project Location Count , State Road, Water Bod ,etc. T� E4c i t`r,rz-� c '� c=� -:` 1 Y y. ) Utz 1- 64 A r
Type and Dimensions of Project
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The proposed project to be located and constructed as described This certification of exemption from. requiring a CAMA permit is
'above is hereby certified as exempt from the CAMA permit re valid for• 0-days from the date of issuance. Followi9pn ex iration
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quirement Thls;ezemption to a re-examination of the project and d project site may be necessary
CAMA permit requirements "does not alleviate the iiecess' of to co
?Y ntinue this certification.
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your obtaining any other State, Federal, or Local authorization:
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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.
BE
Applicant's signature f C-rt==Nr c 0 M MV a l 1-Y owviFm '
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Issuing date
---7j 7-11(.`/
Expiration date
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