General Permits (6101)

-Y
CERTIFICATIO
FROM REQUIRING A C
as authorized by the State of North Car
Department of Environment, Health, a
in an ea of environmental concern p
Applicant Name�
Address C
City
Project Location (County, State Road, Water Body, etc.)
G,,ctGis " AC4v r :� litvt5!cry
-5 Ov V t) ""N Type and Dimensions of Project 7C A 12RC%4
3' C. o u-, r ft 6 L ,a i r=--c.,e M -. 7— 0
an
�l'
N OF EXEMPTION
V
kTfr/� ' �:1
olina, MAR 2 2 1999
Natural Resources and the Coastal Resources Commission
u
rsuant to 15 NCAC Subchapter 7K .0203.
cL'/(o
Phone Number -j -1 - -'4
F_ .o 1_if. lilE
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 >V C Zip � :' % f k-
C c"tiler 'r (-, C_ � C t.' #, c. S r i . f7 y f 15cA
L f4 T-t'----'e- 'L AA oe1 f•- i i' X 9" ' _`%701VRCW, 70
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:
j�� �' ¢ (SCALE: )
%) L J3 EA4,q jCj_ r
`CAT Fc;,(
3�
AxTr-z.[_
_5
I�LooMore-
Q�.
L" fizIU
P4�C dry
;�
,
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.
Applicant's signature
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203