General Permits (8163)

- CERTIFICATION OF EXEM IQN11 19�)
FROM REQUIRING A CAMA PERMITTZ:;
0�as authorized by the State of North Carolina, _ ------------------ 7-7--
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15ANCAC Subchapter 7K .0203.
Applicant Name p / ' Phone Number
Address u
City � State C: Zip 17
Project Location (G,bupty, State Road,,Water Body, ptc.) ��,0 rn ftf Lir•1 ST . RTom. r�. u>grl� AOL
Type and Dimensions of
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 1�\NCAC 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.
SKETCH (SCALE: ( ' . �-_C7 ' ) I
tJeco b
I l i i ►-`L_�tI � 1
f 3�, To
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.
�n rt-r
i�t-"ig
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CAMXOfficial's signature
9
Issuing date
Expiration date
Attachment: 1,9'North Carolina Administrative Code 7K .0203