General Permits (7220)

CERTIFICATION OF EXEMPTION ,tip
0��Y
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 15 NCAC Subchapter 7K .0203.
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Applicant Name )C ./ V FG > r�.r' �,.� Phone Number, 0) _70� _ 3J,6 c. v 9(l
Address ,> � , �/ // rim;
City fus 6,. State aG' Zip oC 5
Project Location (County, State Road, Water'Body, etc.) 132
7- G✓ & cfi`rr i.'� .� o j J �� 6±CP , i s A4iS r
Type and Dimensions of//Proje%�ct // 4 r a. ya *X '
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.
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.
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.
Applicant's signature
CAMA Official's signature
Issuing date—
-��cpiraiion-date--.----------
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Attachment: 15 North Carolina Administrative Code 7K .0203

CARTERET COUNTY COURTHOUSE
CN
CENTRAL PERMIT OFFICE OF
Goa
COURTHOUSE SQUARE
BEAUFORT. N. C. 2851 6-1898
728-8545
BUILDINGS. MOBILE HOMES. ELECTRICAL. PLUMBING. MECHANICAL
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to:
ff i (Id e rN
property located at: u o-irbo LL
near ( water body) '.`i---rrc- - - }ram �S G`r" a, _4 u 7-:'- --Coree-y'
in (county) C---- b , t cf r -
The applicant described to me as shown below, the development
he/she is proposing in that location and:
I have no objections to this proposal!
I do have objections to this proposal
Description and/or drawing of proposed development:
Lture :
Name:
ember:

CEW'RAL PERMIT Or-FICE' OF
rA
4A.
couRrHougE SC4uARE
ADJACENT R'MIAN pROPERTY OWNFA SqT,,A,jjMF,,NT
certify th;it I OwIl PCOPertY a(i-jlaCC:!P't to.
rid
located
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p�c)porty
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C,
tc lr,,e bel,-W,
i.s in that. location and:
th'�s P1:01)0- L
i do have obijections to this PrOPOSEL'
and./or drawing of proposed dovelopmerlt:
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