General Permits (7456)

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CERTIFICATION OF EXEMPTION L,,Z
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
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in an area of environmental concern pursuant to 15nNCAGSubr a'p er 9�63. r� i �.- „ !: �" ,'c > J F, s"
Applicant Name i IB/i' Q 4 / /
Address 1 W 4-1
City , L -r �),
Project Location (County, State Road, Water Body, etc.)
Phone Number 3
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State t./A 'C-1— •! zip 2 3
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Type and Dimensions of Project I '.) 5 '
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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 NOAG• 7K :0209. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
sent of a UAMA otticiai unaer the misiaKen assumPuun 111a< <11G
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-bsentYbtained-fromradjacerit
4andewners- certifying -that-,they have- no objections -to -thee
propase4w alcf
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.
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CAMA Official's sig, ture
Issuing date
Expiration date
.-Attach m oat: 1 &-Nort#r-Garcfi na-Adnrin i9°trativwCode_7&4M,