General Permits (6466)

Applicant Name
Address
City �r
P
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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMITFEB 0 9 1998 jo
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern Pursuant,to,1.5-NC vbchapter-7K-:0/203.
A-7-0evLcrn.� , j SCYi� �Da. Phone Number
Project Locdtion (Co nty, State Road, Water Body, etc.)
State
Zip
Type and Dimensions of Project r�� - =' Asa '/.�> r�f�� (
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 .02G& This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
C-
This c(-rtification 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 Y (SCALE: A;,;,.^ )
,P/ (i E /r �✓Z—
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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Applicant's signature
CAMA Official's signature
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Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203