General Permits (7438)

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Applicant Name _
Address '•� ~�
City
Project Location (C
CERTIFICATION OF EXEMPTION!,
FROM REQUIRING A CAMA PERMIT "P 1 7 201 outR
as authorized b the State of North Carolina `c. n41- C;S�o
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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.;:'"iA _ '
JREHEAD
Phone Number
State Road, Water Body, etc.)
11
State V%.; >- Zip
Type and Dimensions of Project -, `s : �a_:� *_ %?J.
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 cel��f•icatio,n.of exemption from requiring a CAMA permit is
valid fbr 90 days from the date of issuance. Following expiration,
a re-examtnatl6n of the project and project site may be necessary
to continue this certification.
SKETCH (SCALE:{ J` )
Your project is subject to the Tar/Pamlico
River Basin Buffer Rules due to its
location within lheTar/Pamlico Basin.
Please contact Deborah Sawyer or Tom
Steffens at [phone].
• L4'x tWO
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
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.
L
-- "Appli4ant's signature
C fficial's sianature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203