General Permits (6727)

1 • , .J �V
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 ?' C ter 0a
Applicant Name \ � `� e� H ��t` ti Phone Number Zti Z -14,.= •
Address 1 S
City l,J state��- Zip
Project Location (County, State Road, Water Body, etc.) �\_.rx.�• e L 13 50 c c"4'.J�
Type and Dimensions of Project n
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 'i s.from the date of issuance. Following expiration,
quirement pursuant to 7G-YH=*2e& 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.
SKETCH � � i— I � _ , o..^
(SCALE: tvUty )
C)_
i
.I.,,,.,t.,...,, ent , ithni,t the mn- .
sent of a CAMA officiai 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) awritten statement has been obtained from adjacent
landowners certifying that they have, no objections to the
proposed work.
Applicant's si nature
CAMA Off iciars signature
2�A'P(\ L 2-000 _
Issuing date
2000
Expiration date
'At actrment--',-S-North--Carolina-Admirristrative-C-ode-7h--02D3