General Permits (6379)

-� CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, SEA' 2 5 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 , i, i Phone Number'
Address
City ^,` R a i State /fit'_ Zip
Project Location (Gounty, State Road, Water Body,�etc.) , e irt-I r ��4F3� ;'?�`r. �`q y,�y��
Type and Dimensions of Project �.�.rl /
294
The propose protect to be located and constructed as described This certification of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expiration,
quirement pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be necessary
CAMA permit requirements does not alleviate the necessity of to continue this certification. t
your obtaining any other State, Federal, or Local authorization. 1
I SKETCH ��'0 /I "_L4 IV/ , /� (SCALE: / "' //0 ' ) I
j �,(� y J1�0'i'� /t%-ii�.c-�r�tUil- f �'f�J'� �'7rl�il`✓I''
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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.
c
1't;s signat�
i
icial's sianature
/i 71
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203