General Permits (6485)

CERTIFICATION OF EXEMPTION rc"�'i
FROM REQUIRING A CAMA PERMIT AUG 1 7 1998
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources Commi-bon
' rin an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name Iv o& m A;t: C c Phone Number
Address i V
City r State Zip
Project Location (County, State Road, Water Body, etc.)
AJ
Type and Dimensions of Project X
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.
SKETCH T P:
t I• I ; :'K 'i-r-4
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.
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.
(SCALE: )
s
w. i
!) ' t iai t
CAMA Official's signature
'1. Ile
Issuing date 77
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203