General Permits (6633)

i
CERTIFICATION OF EXEMPTION �r
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 15 NCAC Subchapter 7K--.0203. /,.; �_
Applicant Name •J sc iGd « Phone Number
Address I'� c' ` r.-y r ?
City-, % :-n i< State Zip 772
'
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project / f('L 1)111,i 'r A_,
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to ,5&NCME '0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
r�
This certification of exemption from requiring a CAMA permit is
valid for go days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
I SKETCH 6.5 f (SCALE: ) I
KI)TY 11>k r� `t✓----
Vvt. ZAti� -�
�xltjiUG i tonv vC-N4�utau S -ivwv, CLrr•j
i 1 i I.UF 1tLxt D.f 4t A.J i"..� p
i
i
c
Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assumption that the Applicant's signature
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development. CAMA Official's signature
The applicant certifies by signing this exemption that (1) the ap-
plicant has read and will abide by the conditions of this exemp-
tion ada2)-a-writt6.ri-:statement has-been obt4inedl4rdm adjace-nt
landowners certifying that they have -`no obijectiaag7-to :the
.prop. �wor .
Issuin jdate
Expiration date
AttachinGnt: 15 North Carolina Administrative Code 7K .0203