General Permits (7830)

Applicant Name
Address L4
CityJp.
Project Location
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GERT4fleAff-10-W-0E EXEMPTION
FROM REQUIRING A CAMA PERMIT rW
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 concernprr
Phone Number Arta-
(County, State Road, Water BQ.dy, etc.
State
Type and Dimensions of Project
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The proposed project to be located and constructed as described
above.is hereby certified as exempt frorp the CAMA permit re- r
quirement.{)ixsrtant-4 This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
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This certification of exemption from requiring a CAMA permit is
valid. fom90,4�ays from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
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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 exemption that (1) the ap-
plicant has read and will abide by the conditions of this exemp-
tion, and-(2)-awr . om a
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proposed-v �—
�:APlicant's signature.
CAMA Official's signature
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Issuing date
Expiration date