General Permits (5922)

O
CERTIFICATION OF EXEMPTI
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 FS NBCbehapter-elf D2��..
Applicant Name Phone Number tA\L \ --A 3 •
Address 1\ ores
City State Nc= Zip Z.�Z1`1
Project Location (County, State Road„1Nater Body, etc.) �.ia ;�,.r� (-� ~b? ,� `�R �3�q a. L �,nk--ss
aQ,
dh i�i�irc� Vic:.. `•aov4�� 5�� c., �
Type and Dimensions of Project �` c - rf! Z "Y.)c-,AQ.� G oo kr'5
The proposed project to be located and constructed as described
above is hereby certified as exempt from the LAMA permit re-
quirement pursuant to 15--NCPAC`7-K-:{3L03. 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 for9G-,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: ' `��t� 4`•.; )
N
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.
\ i
1 A
LAMA Utticlars signature U
sZ \Cy;(a
Issuing date
�1aJ� \C'ic-7
Expiration date
Attachnjertt:95 North Carolina Administrative Code7K...02.03