General Permits (6139)

I
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, NOV 3 1998
Department of Environment, Health, and Natural Resources and the Coastal Resou''rce� Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K ;020.,:
Applicant Name 1 N Cr t l"ti ''`' %�� }- it c� ! Y l �; rr._�' Phone Number 7'S(�, 7�C6
Address il, r� C y, F i P�
City t .,`) ; �. , �:._,, , _. �_, ,. . . State zip S'
Project Location (County, State'Road, W(atg�r Body, etc.) 444 -
('
Type and Dimensions of Project
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 i02M'_ 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 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: )
r
T, t ►"A
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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(�N LAY -a P 1Jt� W v
Applicant's sig nature
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K 10203