General Permits (6318)

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CERTIFICATION OF EXEMPTION _
FROM REQUIRING A CAMA PERMIT �,�•�-�����
as authorized by the State of North Carolina, q711
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15.NCACSubchapter:7K _O.M.
Applicant Name J C�:rc. 1�~\ Phone Number 'mod _1�13
Address
City <= State zip Q`lq-)J
Project Location (County, State Road,.W• ater Body, etc.) ' �`� `,
r
Type and Dimensions of Project
N- C air 4 1 O 3`F
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 1'5-NCAC-7K..0203. 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: )
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.
Applicant's signature l
CAMA Official's signature
Issuing date
Expiration date
Attach ment:.45-North Card lirfA'Aft 1niffeatiWG6—de-7K":0203