General Permits (6320)

CERTIFICATION OF EXEMPTION
_Y FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, O C T 2 21998
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 `Z cN `• \ NM Phone Number oZ1d 0\'-tka
Address �=), t
City r ,`� ` State
:
Pr{o``ject Location (Gounty, State Road, Water Body, etc.) 4'ew ,
Type and Dimensions of Project e — v�Q �^� c. `l X i
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.
zipa
`,M
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:
,Y
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.
A icant's signature
-� C'� <
CAMA Official's signaftirdN
CA
Issuing date
c
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203