General Permits (6757)

GERT RC T -a�E--EXEMPT ION I- "'I ��Y ,' "
FROM REQUIRING A CAMA PERMIT ,Y (a�
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 �sP:. j -T ?-4 Phone Number zf2 - 521
Address 2 i ,:� i-�►=` ��� .
City State r-4 Zip z
Project Location (County, State Road, Water Body, etc.) I M LV) i
,­: , - L,") r -;-r- z M I r_L,4, c�i rd _ Hwy
Type and Dimensions of Project C E.Pj1 i 244r. :�:r 1-Tr+-I
!�.i _ ' H
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.
This certification-of-exemption-from--requiring-a_CAMA. pexjuit is
valid-for90 days-tier-a-t-he-date-of-issuanee-Foiiowieg-expiratio n,
axe-examinatian of-tha-projeet-and1nzfectsite-may be-neuessar_y-_
to corltirwa_this_cextafieation:-
I SKETCH (SCALE: ,Nn,J,� ) I
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
AWL a subsequent determination that a permit was required for the
Velopment.
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.
Applicant's sign re t
CAMA Official's signatur
Issuing date
E,tc 'r i e
Attachment: 15 North Carolina Administrative Code 7K .0203