General Permits (7176)

CERTIFICATION OF EXEMPTIT�ql
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FROM REQUIRING A CAMA PERMIT ��
as authorized by the State of North Carolina, 16 AU6 ® 919% 1.
Department of Environment, Health, and Natural Resources and the Coastal Re I rces Commission 6
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .020
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Applicant Name -Dili," rj �� a rr ; ; Phone Numbe71 I
Address 'r c
City vtt r (- !I;+K State k 1 Zip ",TV T
Project Location (County, State Road, Water Body, etc.) ((, n s 1 / CC,4 f �.t C� S Cr
Type and Dimensions of Project
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.
Construction of a pier, dock, etc. may also
This certification of exemption from requiring a CAMA permit is
valid for 90 days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
require a building snit.
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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 iciai's signature
Issuing date I
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203