General Permits (6968)

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CERTIFICATION OF EXEMPTION PlIoTo
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, J U L 2 J 2�0
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapfer 7K .0203.
Applicant Name j'� � !`/�' I6/tip' VA t.;; 1.,� _5A,tlu one Number .J 5 �2 t4
Address {'3 �p ! L.; -r7 �r:�-- RJ
City ,s} ,
Project Location (County, State Road, Water Body,, e+.+tc..)
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Type and Dimensions of Project
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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 A O' to continue this certification. _
your obtaining any other State, Federal, or Local authorization. rJ. �m Gk)V /�_
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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 (2) a written statement has been obtained from adjacent
landowners certifying that they have no objections to the
proposed work.
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Applicant's signature
CAMA Officcial's signature
Issuing date
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Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203