General Permits (6476)

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-CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
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 NCAG Subchapter 7K .0203.
Applicant Name c
Address.,
City a
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project
Phone Number
State Zip L^• '-,;
yin r'
The proposed project 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 71<:0203. This exemption to are-examinatiorrofth•eproject and project site may benecessary
CAMA permit requirements does not alleviate the necessity of to continue this -certification.
your obtaining any other State, Federal, or Local authorization.
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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.
Applicant's signature
CAMA Official's signature
Issuing date
Expiration date
'Attachment: 15 North Carolina Administrative Code 7K .0203