General Permits (7656)

CERTIFICATION OF EXEMPTION
FROM
hor!z REQUIRING by the sate ooI
A CAMA PERMIT qUv 2
as4
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission ���
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K.920.
r 4foAppli ant Name &(� � c; Phone Number
Address i
City State �; (L zip ;L j
Project_ Location (County, State Road, Water Body, etc.) cit t-- ci t t .- r
r
f. .1 -
Type and Dimensions of Project (= F Ct ( rlalyowa 15vini'S
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 n 3.,This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA permit is
valid for go days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
(SKETCH (SCALE: ) (
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 • 4hat--they --have- -no--objections- -to- the
proposed-werk.
Hvb(,6
-ant's signature
nature
"., i1—
Issui date
i i ': r; q
Expirafion date,'
Attachment: 15 North Carolina Administrative Code 7K .0203