General Permits (6564)

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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT / ll
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 NCAC..Subchapter 7K .0203;
Applicant Name -Ala4� li/,;(
Address r;
-r
City
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement .pursuant to. 1b.NCAC 7K-.0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
Phone Number
State
Zip
Tbis.c Aifi.cation of exemption.from.requir.ing a CAMA permit is
-va,lid.for,90..days.from-the date of -issuance: -Following expiration,
a.m.exanaipatio.n.of,the_project andproject.site may-be.necessary
to.coniinue .this, certification.
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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.).awritte.n-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