General Permits (7566)

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CERTIFICATION OF EXEMPTION6P
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.
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.)
Phone Number 74-? 6v(_ y ,1 , i
State Zip,^ i
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.
Thiscertification-of-exemption-from-requiringg-"AMAperfnit is
valid for 90 days from the date issuance. Following expiration,
a re-examination of fhe-project and project -site -may be necessary
to -continue -this certification,--
SKETCH (SCALE:
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Any person who proceeds with a development without the con- ,1� <,(- i ,.
sent of a CAMA official under the mistaken assumption that the Applicant's signature
development is exempted, will be in violation of the CAMA if there
a subsequent determination that a permit was required for the
velopment.
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.
CAMA Official's signature_,
i '(R )r�
Issuing date
Expiratioii\."te
Attachment: 15 North Carolina Administrative Code 7K .0203