General Permits (6239)

Road, Watgr Body, etc.)
C 11 QL n ,
O
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, JUN 3 0 1998
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name j. f/-"^
_,.s.
Address Z. f
City KfAh r
Project Location (County,
K'
I ype ana uimensions of rroject
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.
Phone Number 7
State
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 j / 1t1' ,�iX>���AJt: (SCALE: Nf,,; )
tkIFIR kk; ice,=
0, t,
I
� i
1
'Stir'TP
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.
4f,
__7 �
i
Lt T"
Applicant's signature
CAMA Official's signature
Issuing date
Expiratiortdate
Attachment: 15 North Carolina Administrative Code 7K .0203