General Permits (7658)

CERTIFICATION OF EXEMPTION
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 71<.0203- —,pp ,-, .
Applicant Nameff1/d`7%J�'lF t`1/ ��Pr+,�� I't�;, Phone Number
Address_;
City 1s o 'fAr�,�f; t�� fi`✓ State I Zip "
Project LocattionlCounnty, State Road, Water Body, etc.) ,t"'/ a-U,
Type and Dimensions of:Project% %{ �9
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 1,5NCAC 7K .0203.-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 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.
I SKETCH (SCALE: - - ) I
or
!�����!/i r' f 0/1 % may' •'% 1`j%i�e�!� ;% tom 1. 41
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-fhe"--
t proposed work: -
K
Applicant's. signature - '
S
CAMA Official's signature
Issuing date
i
Expiration date
Attachment: IS North Carolina Administrative-Cede-7K-9LO@9--
9