General Permits (5918)

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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 p�
Applicant Name .,,
��,�/n/ic S—.tir7�/�✓rU� Phone Number
Address /rj/ /. Adnip F r c -
City l2A_51-/1k/G -rr) ._l State / c zip
Project Location (County, State_ Road, Water Body, etc.) ZF"FQ,, n" . Sin � r
ems( i e- Ii c .4 /,FLIP . /.a rAZ e-- n
Type and Dimensions of Project RFC,& T om, ,��/'r ,�_
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement ' • +r n,rer �u ..�..
q p 3. This exemption to
CAMA permit requirements does "not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
r ' �/n ' 36 '
This certification of.exemption from requiring a CAMA permit is
valid for 9@�rs 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:
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i l i l i 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.
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signature
CAhy1A gff ral`s sigf'atu`iQe_ — - /
Issuing date -
Expiration date
F .. . a.. e e A —2 — 1