General Permits (7471)

CERTIFICATION OF EXEMPTION rkr
r
FROM REQUIRING A CAMA PERMITA-
`F-
as authorized by the State of North Carolina, NO V 0 3 2005
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 71140reheau (;0ty u(;M
Applicant Name
Address
Citv
Project Location (County, State Road, Water Body, etc.)
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.
State
Phone Number ' ') 4- ` » 5
Zip
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.
is a subsequent determination that a permit was required for the '
CAMA Official's signature
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.
Issuing date
iration date
Attachment: 15 North Carolina Administrative Code 7K .0203