General Permits (6659)

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, a
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 4 t= f �� ! Z;� `'_ Phone Number
Address 1�
City A State Zip 2 7 'i, 2-
ProjectLocation (County, State Road, Water Body, etc.)
Type and Dimensions of Project „c _ ; . Lt t,`� t _':,< (-, ?�:i
. , , _ �; • i i • , ... �--d',(r�. i � l.`=f 1 . LLr- ._.- 1S l� i . �.� /T l=��l r? G'%�.. ,j',C 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 7K .0203. This -exemption to a re-examination of the project and project site may be necessary
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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SKETCH (SCALE: )
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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 't2k�5eexii#raesatt
Applicant's s• nature LL-�
CAMA Official's signature P— JUL 3 o 2007
_ f
Issuing date;
MorheaitY ®C
Expiration date
AftEt '6ht 15:North°tMf6ltffa-Admint§ ativd—Code 7K .0203