General Permits (5982)

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, q� 21 1999
Department of Environment, Health, and Natural Resources and t e oastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name D i Phone Number
Address . 1 `,) P.--;, i7 r,�► 5 �' �^ /i . i� d
City 1
Project Location (County, Slate Road, Water Body,,etc.) 1
CuI\�'s ,.{rA i3-'4.(1.h . .:.}r.-,,A w L
and Dimensions of Project <f p,4 i r-. -f, Xe tr.�
X<-C ed o
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.
State N C. Zip e
[x/I ri A (r4,1 04 P,i. (II ,vr%I
e key
This certification 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: !'�v f ?- j < )
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 4icant's signature �J
LAMA Off icial'ss'stpngiure (I
Issuing date _,^ /
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203