General Permits (7757)

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CERTIFICATION OF EXEMPTION
Y 0 2000
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. _f H
Applicant Name-r 1 j 4i F C j �1 r117 5u 1�i�j r: Phone Number
Address /" rtf� ,tk Vit-.0-i 0d .
City kt , - ';(. ;F ! ! r. (. State Al Zip 7')et
Project Location (County, State Road, Water Body, etc.) SA NL I)A it r �> .
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Type and Dimensions of Project I (,v &1 ri . i,: ' )' S '
The proposed project to be located and constructed as described
above
. This �
CAMA permit requirement% does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This permit is
valid for g0 days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue
SKETCH (SCALE: `` )
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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 arMSM&Wthat (1) the ap-
plicant has read and will abide by the conditions of this 4mUNW
*w, and (2) a written statement has been obtained from adjacent _
landowners certifying that they have no objections to the
proposed work.
L
Applicant's signature f
LAMA Official's sianature
-
Issuing date
Expiration date
6`7f to 6
Attachment: 15 North Carolina Administrative Code