General Permits (6844)

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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 l-5-14GAC-Subehapter 7K -.0203.
ADDlicant Name .:,1r.., ��� ..Ll�/ a f c` Phone Number
Address•.�-
CityState Zip
Project Location,(County, State Road, Water Body, etc.) f
Type and Dimensions of Project �s'riYr�r `—` 'a2�';
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- NGAC -7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This-e`+tification of exemption -from requiring -a CAMA-permit-is
-valid for-90-days from thedate of•issuanee: Feilowing-expifation,
- a•re-examination of -the project -and -project site maytre necessary
to continue this,certificataon:-
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Any person wno proceeas wnn a aeveiopmem wnnoui uie wn-
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)•a written -statement has-beenobtai ned-f rom -adjacent,
landowners --certifying•-that - they--have•-ne objections. -to -.the
.proposed work.
Applicant's signature,
CAMA Official's signature
Issuing date
Expiration date
Attachment-: 45 North Carolina -Administrative Code-i4-•020a