General Permits (8138)

CERTIFICATION OF EXEMPTLAU61\1'­
FROM REQUIRING A CAMA PERMIT 4 19
as authorized by the State of North Carolina, jrjuLZLP
Department of Environment, Health, and Natural Resources and the Coastal•Fissewtcei.QgMMission_
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203. �-�`
Applicant Name / A /'�; 4er—n h
Address iJ-
City,-
Project Location (County, State Road, Water Body, etc.)
Phone Number Z Z'j -S-1 /Si
State ,✓I <_ - ,Zip
Type and Dimensions of Project ttF o 1,' ca u,T -� u cf i asJ 1) 1 c-ru r lr�.�.t.. D ems,
c..,( 1/I
The proposed projeof 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.
/ /0 'X 16
Cfr-A i4c, 4 Ott GIZ'c' f T
This certification of exemption from requiring a CAMA permit id
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.
SKETCH F fl (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 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.
I
s sicnat
CAMA icial's signature
Issuing date
Expiration date
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Attachment: 15 North Carolina Administrative Code 7K .0203